This study was undertaken to compare with previously published findings in normal subjects and subjects after
truncal vagotomy and antrectomy the effects of nonresective
ulcer surgery on (a) gastric emptying, grinding, and sieving of solid food and on (b) pancreatic and biliary secretions. Six subjects with
proximal gastric vagotomy and 7 subjects with
truncal vagotomy with pyloroplasty were studied using a previously validated
indicator perfusion system with its aspiration port placed in the proximal jejunum. All subjects were given a meal of 30 g of 99mTc-liver, 60 g of beefsteak, and 100 ml of H2O. In conjunction with a
gamma-camera to measure total gastric emptying of 99mTc-liver, this method allowed us to estimate the fraction of 99mTc-liver emptied from the stomach as particles of less than 1-mm diameter; in addition, we were able to measure jejunal concentrations and outputs of
bile salts and pancreatic
enzymes. In subjects with
proximal gastric vagotomy, all parameters studied were indistinguishable from normal. Subjects with
truncal vagotomy and pyloroplasty behaved similarly to subjects with
vagotomy and antrectomy, showing (a) early precipitous emptying of food, (b) heterogeneous distribution of half-emptying times, (c) near normal concentration of biliary and pancreatic secretions, (d) markedly reduced jejunal flow rates, and (e) a reduction in postcibal
trypsin secretion. In contrast to subjects after
truncal vagotomy and antrectomy, however, the majority of subjects with
vagotomy and pyloroplasty did not show a persistent defect in grinding and sieving of solid food.