Effects of selective gastric vagotomy and pyloroplasty on oral and intravenous glucose tolerance and insulin secretion
R. Bittner, H. G. Beger, E. Kraas and H. Gogler
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 of the
undisturbed glucose tolerance.