[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
August 1976

Effects of Selective Gastric Vagotomy and Pyloroplasty on Oral and Intravenous Glucose Tolerance and Insulin Secretion

Author Affiliations

From the Department of Surgery, Klinikum Charlottenburg, Free University of Berlin.

Arch Surg. 1976;111(8):850-853. doi:10.1001/archsurg.1976.01360260018003
Abstract

• In peripheral and portal venous blood, the immunoreactive insulin (IRI) and glucose levels in response to orally and intravenously administered glucose were measured in 14 patients with selective gastric vagotomy and pyloroplasty (SGV+P) and in 17 control subjects with other abdominal surgery.

After intravenously administered glucose, the insulin and the glucose levels were nearly identical in both groups. After orally administered glucose, there were remarkable differences. Despite their early postoperative situations, and in contrast to the control patients, the SGV+P subjects showed no hyperglycemia. The measurements of IRI in the portal vein suggested that in SGV+P patients, the response of the islet cells is accelerated.

In patients with SGV+P, the release of an insulinotropic intestinal factor and the preserved vagal innervation of the pancreas may be responsible for the accelerated insulin response and the undisturbed glucose tolerance.

(Arch Surg 111:850-853, 1976)

References
1.
Lapp FW, Dibold H:  Blutzuckerablauf in seiner Beziehung zum resezierten Magen .  Klin Wochenschr 12:547-548, 1933.Crossref
2.
Beckermann F:  Über spontane Hypoglykämie nach Magenperforation  Dtsch Med Wochenschr 59:683-684, 1933.Crossref
3.
Wells CH, Welbourn R:  Post-gastrectomy syndromes .  Br Med J 1:546-554, 1951.Crossref
4.
Hall WH, Sanders LL, Read RC:  Effect of vagotomy and pyloroplasty: The oral glucose tolerance test .  Gastroenterology 64:217-222, 1973.
5.
Roth DA, Meade RC:  Hyperinsulinism-hypoglycemia in the postgastrectomy patient .  Diabetes 14:526-528, 1965.
6.
Amdrup E, Kortholm B, Nielsen S:  Glucose tolerance curves after partial gastrectomy .  Acta Chir Scand 131:461-472, 1966.
7.
Cameron AJ, Ellis JP, McGill JI, et al:  Insulin response to carbohydrate ingestion after gastric surgery with special reference to hypoglycaemia .  Gut 10:825-830, 1969.Crossref
8.
Breuer RI, Moses H, Hagen THC, et al:  Gastric operations and glucose homeostasis .  Gastroenterology 62:1109-1119, 1972.
9.
Shultz KT, Neelon FA, Nilsen LB, et al:  Mechanism of postgastrectomy hypoglycemia .  Arch Intern Med 128:240-246, 1971.Crossref
10.
Holdsworth CD, Turner D, McIntyre N:  Pathophysiology of post-gastrectomy hypoglycaemia .  Br Med J 4:257-259, 1969.Crossref
11.
Thomford NR, Sirinek K, Crockett SE:  Gastric inhibitory polypeptide .  Arch Surg 109:177-182, 1974.Crossref
12.
Kaneto A, Kosaka K:  Stimulation of glucagon and insulin secretion by acetylcholine infused intrapancreatically .  Endocrinology 95:676-681, 1974.Crossref
13.
Kaneto A, Miki E, Kosaka K:  Effects of vagal stimulation on glucagon and insulin secretion .  Endocrinology 95:1005-1010, 1974.Crossref
14.
Beger HG, Witte CH, Meves M, et al:  Erfahrungen mit organerhaltenden Operationsmethoden in der Behandlung des Magen-Zwölffingerdarm-Geschwürs .  Chirurg 43:127-131, 1972.
15.
Eisele R, Beger HG, Kintzonidis D, et al:  Die langfristige Katheterisierung des Pfortader Gefäszsystems nach abdominellen Operationen beim Menschen .  Z Ges Exp Med 149:356-358, 1969.Crossref
16.
Hales CN, Randle PJ:  Immunoassay of insulin with insulin-antibody precipitate .  Biochem J 88:137-146, 1963.
17.
Schmidt FH:  Enzymatische Methoden zur Bestimmung von Blut- und Harnzucker unter Berücksichtigung von Vergleichsuntersuchungen mit klassischen Methoden .  Internist 4:554-559, 1963.
18.
Welborn TA, Rubenstein AH, Haslam R, et al:  Normal insulin response to glucose .  Lancet 1:280-284, 1966.Crossref
19.
Amatuzio DS, Stutzman FL, Vanderbilt MJ, et al:  Interpretation of the rapid intravenous glucose tolerance test in normal individuals and in mild diabetes mellitus .  J Clin Invest 32:428-435, 1953.Crossref
20.
Nelson N, Guzzetta DR, Kinder JL, et al:  The effect of vagotomy on glucose tolerance .  Am Surg 34:26-30, 1969.
21.
Aagaard P, Deckert T, Fenger HJ:  Serum insulin after intravenous administration of glucose before and after total vagotomy .  Scand J Gastroenterol 8:699-701, 1973.
22.
Lindseth RE:  Postoperative glucose metabolism in diabetic and nondiabetic patients .  Arch Surg 105:741-745, 1972.Crossref
23.
Ross H, Johnston IDA, Welborn TA, et al:  Effect of abdominal operation on glucose tolerance and serum levels of insulin growth hormone and hydrocortisone .  Lancet 2:563-566, 1966.Crossref
24.
Beger HG, Bittner R, Kraas E, et al:  Der Einflusz von Gastrin auf die Insulinsekretion Langenbecks .  Arch Chir 37( (suppl) ):259-262, 1973.
25.
Cataland S, Crockett SE, Brown JC, et al:  Gastric inhibitory polypeptide (GIP) stimulation by oral glucose in man .  J Clin Endocrinol Metab 39:223-228, 1974.Crossref
26.
Creutzfeldt M:  Insulin-releasing factors of the gastrointestinal mucosa (incretin) in progress in gastroenterology .  Gastroenterology 67:748-750, 1974.
27.
McIntyre N, Holdsworth CD, Turner DS:  Intestinal factors in the control of insulin secretion .  J Clin Endocrinol 25:1317-1324, 1965.Crossref
28.
Unger RH, Eisentraut AM:  Entero-insular axis .  Arch Intern Med 123:261-266, 1966.Crossref
×