The gastric peptic ulcer operation is designed to reduce the gastric secretion, of gastric acid and pepsin enough to control the peptic ulcer diathesis and also to lessen the complications after the operation which are related to alterations of
the
gastric motility and the emptying rate.
The author studied the physiologic effects of proximal gastric vagotomy, subtotal gastrectomy, truncal vagotomy and truncal vagotomy with pyloroplasty on the gastric secretion, gastric acid, gastric pepsin, gastric motility and gastric emptying
rate,
and gastric pressure/volume relationship.
In these exprimental studies, 2 kinds of animals i.e. dogs and cats, were used. 15 dogs were used which were divided into 5 groups i.e. gastrostomy for control, proximal gastric vagotomy, subtotal gastrectomy, truncal vagotomy only and truncal
vagotomy
with gastric pyloroplasty. 25 cats were used which were divided into 3 groups i.e. gastrostomy for control, proximal gastric vagotomy and truncal vagotomy and the following results and' conclusion were obtained.
1) Vagotomy has an important role on the gastric secretion, gastric acid, gastric pepsin, gastric motility, gastric omptying and the relationship between the intragastric pressure and volume.
2) Both proximal gastric vagotomy and subtotal gastrectomy(Billroth I) made a marked reduction on the gastric secretion, gastric acid and gastric pepsin compared to that of the control group but were similar to the control group on the gastric
motility
and gastric emptying rate.
3) Truncal vagotomy alone caused marked reduction on gastric secretion, gastric acid and gastric pepsin and showed a remarkable slowing of the gastric motility and the gastric emptying rate.
And the truncal vagotomy with pyloroplasty caused a marked reduction in gastric secreting acid and pepsin.
4) The wave of contraction and motility index in duodenum were higher than that of the gastric body and antrum and the antral contraction was higher than that of gastric body in control groups.
5) The pacesetter potential of gastric motility starts on gastric corpus and propagates aforally in part and pacesetter potential in gastric curvature propagates transversally is formed by gastric intrinsic myogenic phenomena and is related to
motor
activity and gastric emptying.
6) The truncal vagotomy with pyloroplasty hastened the gastric emptying rate of liquid meals and the rate of emptying of solid meals was slightly faster than that of the control group.
7) The liquid meal is controlled by vagus and intragastric transmural pressure and the emptying of liquid is rapid after vagotomy and the distal antrum and pylorus are of great importance in gastric emptying of solid meals
8) The vagus distributed on the stomach was divided into cholinergic excitory fibers and noncholinergic or nonadrenergic inhibitory fibers. As gastric vagal inhibitory fibers were cut when vagotomy was done, pyloroplasty must be done.
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