Effect of extended parietal cell vagotomy on long-term nutrition and digestive function.

OBJECTIVE

To study the effect of extended parietal cell vagotomy (EPCV) on long-term nutritional status and digestive-absorption function.

PATIENTS AND METHODS

Thirty-six patients undergoing EPCV were compared with 30 patients with subtotal gastrectomy (SG) 7-14 years after operation. The patients were evaluated in terms of nutritional status, gastric secretion, gastrointestinal motility, and intestinal digestive-absorption function.

RESULTS

The nutritional status was generally less satisfactory in 33.3% patients with anemia after SG and body weight decreased in 54%. The patients after EPCV were all in good nutritional status, and had no symptoms of anemia; 56% of them had body weight increased by more than 3 kg. The mean basal acid output (BAO), maximal acid output (MAO), and peak acid output (PAO) of the EPCV group were significantly reduced after operation (P < 0.01), and moderately reduced as compared with those of the control group (P > 0.05). But the BAO, MAO, and PAO of the SG group were more markedly reduced than those of the control group (P < 0.001) before operation. Vitamin B12, folacin, intrinsic factor and iron protein level of serum in the EPCV group were slightly decreased as compared with those of the control group (P > 0.05), but more significantly decreased in the SG group than in the control group (P < 0.001). Iron protein and intrinsic factor level was lower than the normal level. The gastric emptying time and small intestinal passthrough time of EPCV were more close to the normal physiological status, but in the SG group, they were significantly fast (P < 0.001). The results of intestinal D-xylose absorption test in EPCV and SG groups were similar (P > 0.05).

CONCLUSIONS

EPCV is capable of preserving gastric acid of physiologic level and normal digestion-absorption function. The effect of EPCV on long-term nutrition and digestion absorption function was extremely milder than that of SG. Therefore, a theoretical basis is provided for the rationality of EPCV.