Interrelationship between serum gastrin concentration, gastric acid secretion, and gastric emptying rate in recurrent peptic ulcer.

In 36 patients with recurrent peptic ulcer after surgery (11 partial gastrectomy, 25 vagotomy with or without drainage), 12 had a gastric and 24 an intestinal recurrence. Gastric recurrence after partial gastrectomy was characterized by retained antral tissue and a marked serum gastrin response to feeding. Fasting serum gastrin concentration and gastric acid secretion were not correlated with the location of the recurrent ulcer. Gastric recurrences in patients treated by vagotomy correlated mainly with prolonged gastric emptying, and basal acid secretion was significantly lower than in patients with intestinal recurrence. Following complete vagotomy, the recurrence was usually gastric, but it was intestinal after incomplete vagotomy. In the vagotomy group, no correlations between location of ulcer and pentagastrin-stimulated acid secretion, or fasting and foodstimulated serum gastrin concentrations were found.