{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T08:23:30Z","timestamp":1776587010184,"version":"3.51.2"},"reference-count":18,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1982,8]]},"abstract":"<jats:p>The effects of fundic vagotomy on acid and pepsin secretion in 12 patients (10 males, two females; nine duodenal ulcer, three gastric ulcer) were studied using a pentagastrin dose response before and after Vagotomy. In the intact stage H, Cl, and pepsin output all had the same ED50, 120-127 pmol\/kg\/h. Vagotomy reduced basal output of acid by 78%, Cl- by 50%, and pepsin by 62%. Postvagotomy basal outputs were not related to preoperative levels, while maximum acid output was reduced by an average of 35%, proportionally to the preoperative output (r = 0.94). Vagotomy uncompetitively (ED50 increase, Vmax decrease) inhibited the pentagastrin dose response of acid, chloride, and pepsin output. Postoperatively, a six-fold greater dose of pentagastrin (450 vs 76 pmol\/kg\/h) was required to stimulate acid to 50% of its preoperative maximum output. For pepsin secretion the increase was 12-fold (185 vs 15 pmol\/kg\/h). In five of the nine duodenal ulcer patients pentagastrin dose responses were repeated with a background infusion of urecholine, 20 micrograms\/kg\/h. Urecholine increased basal and peak acid, pepsin, and chloride outputs, and the ratio of basal: maximal almost to prevagotomy levels; it also restored the sensitivity to pentagastrin. Serum gastrin was not significantly changed by urecholine or by vagotomy. We conclude that the level of basal acid and pepsin secretion in ulcer patients, which is largely eliminated by vagotomy, is dependent on the vagus and not on serum gastrin. The effects of vagotomy are functional, are due to cholinergic withdrawal, and usually can be restored by cholinergic replacement.<\/jats:p>","DOI":"10.1136\/gut.23.8.675","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"675-682","source":"Crossref","is-referenced-by-count":13,"title":["Effects of fundic vagotomy and cholinergic replacement on pentagastrin dose responsive gastric acid and pepsin secretion in man."],"prefix":"10.1136","volume":"23","author":[{"given":"B I","family":"Hirschowitz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C A","family":"Helman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1982,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1152\/ajplegacy.1975.228.5.1313","article-title":"Effects of vagotomy on urecholine-modified histamine dose responses in dogs","volume":"228","author":"Hirschowitz, B.I.; Hutchison, G.","year":"1975","unstructured":"Hirschowitz BI, Hutchison G. Effects of vagotomy on urecholine-modified histamine dose responses in dogs. Am J Physiol 1975; 228: 1313-8.","journal-title":"Am J Physiol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/BF01072948","article-title":"Long-term effects of highly selective vagotomy (HSV) in dogs on acid and pepsin secretion","volume":"22","author":"Hirschowitz, B.I.; Hutchison, G.","year":"1977","unstructured":"Hirschowitz BI, Hutchison G. Long-term effects of highly selective vagotomy (HSV) in dogs on acid and pepsin secretion. Am J Dig Dis 1977; 22: 81-95.","journal-title":"Am J Dig Dis"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/00365521.1975.12096971","article-title":"Effect of urecholine and carbacholine on pentagastrin-stimulated gastric secretion after proximal gastric vagotomy in duodenal ulcer patients","volume":"10","author":"Roland, M.; Berstad, A.; Liavag, I.","year":"1975","unstructured":"Roland M, Berstad A, Liavag I. Effect of urecholine and carbacholine on pentagastrin-stimulated gastric secretion after proximal gastric vagotomy in duodenal ulcer patients. Scand J Gastroenterol 1975a; 10: 315-9.","journal-title":"Scand J Gastroenterol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/00000658-197101000-00009","article-title":"Effect of truncal vagotomy on acid and pepsin responses to histamine in duodenal ulcer subjects","volume":"173","author":"Rosato, E.F.; Rosato, F.E.; MacFadyen, B.","year":"1971","unstructured":"Rosato EF, Rosato FE, MacFadyen B. Effect of truncal vagotomy on acid and pepsin responses to histamine in duodenal ulcer subjects. Ann Surg 1971; 173: 63-6.","journal-title":"Ann Surg"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"577","DOI":"10.3109\/00365528109182014","article-title":"Review: Completeness of vagotomy: anatomy, pathophysiology and consequences","volume":"16","author":"0, Kronborg","year":"1981","unstructured":"Kronborg 0. Review: Completeness of vagotomy: anatomy, pathophysiology and consequences. Scand J Gastroenterol 1981; 16: 577-80.","journal-title":"Scand J Gastroenterol"},{"key":"ref_6","first-page":"373","article-title":"The effect of vagotomy on the maximal acid secretory response to histamine in man","volume":"22","author":"Payne, R.A.; Kay, A.W.","year":"1972","unstructured":"Payne RA, Kay AW. The effect of vagotomy on the maximal acid secretory response to histamine in man. Clin Sci 1972; 22: 373-82.","journal-title":"Clin Sci"},{"key":"ref_7","first-page":"1421","article-title":"Long-term effect of highly selective vagotomy on basal and maximal","volume-title":"output in man. Gastroenterology 1975","volume":"68","author":"Greenall, M.J.; Lyndon, P.J.; Goligher, J.C.; Johnston, D.","unstructured":"Greenall MJ, Lyndon PJ, Goligher JC, Johnston D. Long-term effect of highly selective vagotomy on basal and maximal output in man. Gastroenterology 1975; 68: 1421-5."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1080\/00365521.1975.12096980","article-title":"Decrease in gastric secretion during the first three months after proximal gastric vagotomy in duodenal ulcer patients","volume":"10","author":"Roland, M.; Berstad, A.; Liavag, I.","year":"1975","unstructured":"Roland M, Berstad A, Liavag I. Decrease in gastric secretion during the first three months after proximal gastric vagotomy in duodenal ulcer patients. Scan J Gastroenterol 1975c; 10: 363-7.","journal-title":"Scan J Gastroenterol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1080\/00365521.1975.12096979","article-title":"Effect of carbacholine on pentagastrin-stimulated gastric secretion in healthy subjects","volume":"10","author":"Roland, M.; Berstad, A.; Liavag, I.","year":"1975","unstructured":"Roland M, Berstad A, Liavag I. Effect of carbacholine on pentagastrin-stimulated gastric secretion in healthy subjects. Scand J Gastroenterol 1975b; 10: 357-62.","journal-title":"Scand J Gastroenterol"},{"key":"ref_10","first-page":"525","article-title":"A comparative study of the effects of gastrin, histamine, histalog and mechothane on the secretory capacity of the human stomach in two normal subjects over 20 months","volume-title":"Gut","volume":"6","author":"Makhlouf, G.M.; McManus, J.P.A.; Card, W.I.","year":"1965","unstructured":"Makhlouf GM, McManus JPA, Card WI. A comparative study of the effects of gastrin, histamine, histalog and mechothane on the secretory capacity of the human stomach in two normal subjects over 20 months. Gut 1965; 6: 525-34."},{"key":"ref_11","first-page":"15","article-title":"Le dosage automatique de l'activite proteolytique du suc gastrique","volume":"1","author":"Vatier, M.M.; Cheret, A.A.; Bonfils, S.","year":"1968","unstructured":"Vatier MM, Cheret AA, Bonfils S. Le dosage automatique de l'activite proteolytique du suc gastrique. Bio Gastroenterol 1968; 1: 15-29.","journal-title":"Bio Gastroenterol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1080\/00365521.1973.12096752","article-title":"A working hypothesis for urecholine effects on histamine stimulation of gastric secretion","volume":"8","author":"Hirschowitz, B.I.; Hutchinson, G.H.","year":"1973","unstructured":"Hirschowitz BI, Hutchinson GH. A working hypothesis for urecholine effects on histamine stimulation of gastric secretion. Scand J Gastroenterol 1973; 8: 569-76.","journal-title":"Scand J Gastroenterol"},{"key":"ref_13","article-title":"An evaluation of the insulin test","author":"0, Kronborg","year":"1972","unstructured":"Kronborg 0. An evaluation of the insulin test. Copenhagen: Fadls Forlag, 1972."},{"key":"ref_14","first-page":"392","article-title":"Effect of medical and surgical vagotomy on gastric response to graded doses","volume-title":"of pentagastrin and histamine. Gastroenterology 1968; 54","author":"Konturek, S.J.; Wysocki, A.; Olesky, J.","unstructured":"Konturek SJ, Wysocki A, Olesky J. Effect of medical and surgical vagotomy on gastric response to graded doses of pentagastrin and histamine. Gastroenterology 1968; 54: 392-400."},{"key":"ref_15","first-page":"832","article-title":"Dose response studies of acid secretion after administration of tetragastrin. Studies in duodenal ulcer patients before and after highly selective vagotomy, hemigastrectomy and truncal vagotomy plus antrectomy","volume":"139","author":"Csendes, A.; Ornsholt, J.; Venturelli, A.; Henriquez, A.","year":"1980","unstructured":"Csendes A, Ornsholt J, Venturelli A, Henriquez A. Dose response studies of acid secretion after administration of tetragastrin. Studies in duodenal ulcer patients before and after highly selective vagotomy, hemigastrectomy and truncal vagotomy plus antrectomy. Am J Surg 1980; 139: 832-7.","journal-title":"Am J Surg"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"275","DOI":"10.3109\/00365526709180082","article-title":"Mechanism of the vagotomy-induced suppression of the maximal acid response to histamine in antrectomized duodenal ulcer patients","volume":"2","author":"Broome, A.","year":"1967","unstructured":"Broome A. Mechanism of the vagotomy-induced suppression of the maximal acid response to histamine in antrectomized duodenal ulcer patients. Scand J Gastroenterol 1967; 2: 275-82.","journal-title":"Scand J Gastroenterol"},{"key":"ref_17","first-page":"458","article-title":"The naso-gastric tube during a gastric secretion study. Br pharmacological basis of therapeutics, Chapter 5","volume":"1","author":"M, Berstad A, Liavag I.; Goodman, A.G.; Goodman, L.S.; Gilman, A.; eds","year":"1970","unstructured":"Goodman AG, Goodman LS, Gilman A, eds. The naso-gastric tube during a gastric secretion study. Br pharmacological basis of therapeutics, Chapter 5. New Med J 1970; 1: 458-60. York, NY: McMillan, 1980. 19 Roland M, Berstad A, Liavag I. Scand J Gastroenterol","journal-title":"New Med J"},{"key":"ref_18","first-page":"511","article-title":"Positioning of subject and of","volume":"9","author":"Hassan, M.A.; Hobsley, M.","year":"1974","unstructured":"Hassan MA, Hobsley M. Positioning of subject and of 1974; 9: 511-8."}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.23.8.675","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T20:11:47Z","timestamp":1757275907000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.23.8.675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1982,8]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[1982,8,1]]},"published-print":{"date-parts":[[1982,8]]}},"alternative-id":["10.1136\/gut.23.8.675"],"URL":"https:\/\/doi.org\/10.1136\/gut.23.8.675","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1982,8]]}}}