Physiologic significance of the residual stomach after proximal gastrectomy from the view-point of serum gastrin.

The physiological significance of the residual distal stomach after proximal gastrectomy (PG) was evaluated in dogs from the view-point of serum gastrin. The fasting gastrin levels in both (1/2 and 2/3) PG groups were high, especially in the 1/2 PG group. The serum gastrin levels did not decrease with time after test meal stimulation in both PG groups. This points to a disturbance of the short loop feedback mechanism in gastric secretion due to a reduction in gastric acid secretion. The elevated gastrin secretion after PG may be beneficial for postoperative digestion and absorption of food. Therefore, it is important when possible, to preserve the distal stomach of operated gastric cancer patients, and to select a reconstructive procedure which permits passage of food through the preserved distal stomach.