Physiological and light-electron microscopical studies of parietal cells and G cells before and after selective vagotomy with pyloroplasty.

The function of residual parietal cells and G cells following selective vagotomy with pyloroplasty (SV + P) in 21 duodenal ulcer patients was assessed by light-electron microscopical studies of gastroendoscopic biopsy material and determination of gastric acid secretion and serum gastrin levels. The postoperative decrease in number of parietal cells was not so great when compared with the reduction of acid secretion. However, the ultrastructural changes of parietal cells suggested hypofunction of the cells. In addition, the response of parietal cells to histalog stimulation was also decreased according to morphological observations under electron microscope. Basal plasma gastrin was significantly increased (p < 0.01) one month after surgery. Integrated gastrin response (IGR) to meat extract and insulin hypoglycemia stimulation was also increased significantly (p < 0.01) six months postoperatively. The G cells were still increasing in number six months after SV + P, and G cell hyperplasia became more remarkable after one year. Emiocytotic figures were observed in denervated G cells which were stimulated by meat extract or insulin hypoglycemia. On the basis of the findings of this study, it is considered necessary to conduct complete vagotomy on the parietal cell region when SV + P is performed.