After truncal vagotomy with Heineke-Mikulicz pyloroplasty or truncal vagotomy with Billroth I-type reconstruction biopsies of the gastric remnant obtained 1, 3, and 6 months postoperatively failed to demonstrate any significant alteration from the control level in the numbers of parietal cells. Administration of histamine in beeswax for 10 days resulted in essentially the same degree of parietal cell hyperplasia in these animals as was observed in dogs with intact stomachs. On the other hand, vagotomy and antrectomy, with Billroth II-type reconstruction eventuated in marked mucosal changes in the residual gastric pouch, such that by 6 months postoperatively the mean number of parietal cells was diminished by 58% and the mucus-secreting cells were markedly increased. Histologic examination of longitudinal strips of gastric mucosa taken at right angles to the gastrojejunostomy showed that within 3-5 cm. of the anastomoses there existed virtually no parietal cells. Instead the mucosa was characterized by an inflammatory round cell infiltrate, mucus cell hyperplasia, and cystic dilatation of the glands. It is concluded that vagotomy and antrectomy, per se, do not significantly alter the parietal cell population in the normal canine stomach. However, diminution of secretory elements does develop after vagotomy and antrectomy when the gastric remnant is bathed in jejunal contents. These observations explain the progressive atrophic gastritis commonly noted after partial gastrectomy when Billroth II reconstruction is employed.
Bibliographical noteFunding Information:
From the Dcpnrtment of Snrycry. University Minnesota Health Scicnws C<,ntcr, Minnrapolia, Minnesota 55455. Snpportrd by USPHS Grant 5ROl-AM-12344-02. 1 I’rcwnt address : Division of Surgery. ffnltel Rred Army Institute of Rrscnrcl~. Walter Reed Arm> Medical Crntcr, W:Aington, D.C. 20012. Suhmittcd for public:ltion August 16, 19il.