June 1964

Pyloric Effects on Gastric Secretion And Emptying

Author Affiliations

From the Department of Surgery and Surgical Research, Veterans Administration Hospital.

Arch Surg. 1964;88(6):1052-1058. doi:10.1001/archsurg.1964.01310240148025

It was first demonstrated in 1952 that vagotomy to the stomach of a Heidenhain pouch dog caused a significant increase in acid secretion from the pouch.4,9

The chief cause of this phenomenon is felt to be due to excessive antral stimulation which results in an increased liberation of gastrin. Excessive gastrin, in turn, causes hypersecretion of acid.

The excessive antral stimulation has been explained in two ways. One is that vagotomy causes antral stasis with decreased gastric emptying leading to increased physical and chemical stimulation of the antrum.3 The other cause is ascribed to decreased acid inhibition of the antrum resulting from vagotomy to the main stomach.4

Other factors might play a role in the causation of excessive antral stimulation following vagotomy. Since the pylorus occupies a unique location at the exit of the stomach, it has been incriminated as a governing factor in gastric evacuation. The

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