Effect of parietal cell vagotomy on gastric emptying in duodenal ulcer disease.

Gastric emptying was delayed preoperatively in 9 of 19 patients with duodenal ulcer disease, but all 9 patients with evidence of retention by scan were asymptomatic; gastric emptying was normal in the remaining 10 patients. A significant delay in gastric emptying was documented by scan in 17 of 19 patients immediately after parietal cell vagotomy (despite the absence of symptoms of gastric retention). Delayed emptying was demonstrated in three patients who were restudied more than 1 year after parietal cell vagotomy; again these patients had no symptoms of gastric retention at any time. A sustained reduction in basal and stimulated acid secretion in both the early and late postoperative period was documented in all 19 patients, and serum gastrin levels also remained low. This absence of acid or gastrin stimulation is corroborated by the fact that there was no recurrence of ulcers in these patients during a follow-up period of up to 37 months.