Research Article| Volume 115, ISSUE 2, P157-164, February 1968

Effect of antrectomy on gastric acid hypersecretion induced by isolation of the proximal small bowel

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      Significant gastric acid hypersecretion from Heidenhain pouches follows conversion of the upper half of the small bowel below the pancreatic ducts into a defunctionalized Thiry fistula, or excision of this segment. Since comparable hypersecretion is produced by both procedures, this hyperacidity is probably due to the removal of a gastric acid inhibitor normally released by this segment of the bowel.
      Antrectomy with Billroth I type reconstruction radically reduces this acid hypersecretion well below base line controls, suggesting that the normal intestinal inhibition of acid is directed against antial gastrin.
      If the antrectomy is performed first, and the Thiry fistula formed later, the fistula induces a modest increase in acid, and subsequent excision of the fistula lowers acid levels to those expected after antrectomy alone. This reaction after antrectomy suggests that significant lengths of defunctionalized bowel also have the potential of releasing an acid-stimulating hormone.
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