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Physiological and Light-electron Microscopical Studies of Parietal Cells or G Cells before and after Antrectomy and Selective Vagotomy with Pyloroplasty or Antrectomy Y. Watanabe 1 , T. Kidokoro 1 , Y. Sawada 1 , K. Kato 1 , H. Miyagami 1 , K. Kondo 1 1Department of Surgery, Juntendo University, School of Medicine pp.773-784
Published Date 1978/6/25
DOI https://doi.org/10.11477/mf.1403107345
  • Abstract
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 In order to examine the relation between preserved parietal cells and gastric acid secretion, we studied the numbers of parietal cells and ultrastructural changes using materials obtained by gastroendoscopic biopsy. Gastric acid secretion were measured before and after selective operations for duodenal ulcer. As operative procedures, antrectomy, vagotomy with pyloroplasty or antrectomy were selected by acid secretory responses to medical vagotomy of Gillespie & Kay (1961). After the operation, the decrease in number of parietal cells was not so great as compared with the reduction of acid secretion. However, the ultrastructural changes of parietal cells suggesting the hypofunction of the cells were observed. In addition, the response of parietal cells to histalog stimulation decreased postoperatively, according to morphological observations under electron microscope. These data suggest that the decrease in postoperative gastric acid secretion be due to the decreased sensitivity of parietal cells. On the other hand, in order to assess the function of the retained antrum following the SV+P for duodenal ulcer patients, we measured the plasma gastrin and observed the G cells under electron microscope.

 Basal plasma gastrin increased significantly one month postoperatively (p<0.01). Integrated gastrin response (IGR) to meat extract stimulation increased significantly six months postperatively (p<0.01). Despite gastric vagotomy, IGR after insulin hypoglycemia stimulation increased three months postoperatively (p<0.01). The G cells after SV+P did not show any fine-structural features suggesting hypofunction and degeneration. On the contrary, they showed hyperfunctional and presecretory state. The G cells were increasing in number six months after operation, and then G cell hyperplasia became more remarkable one year postoperatively. Emiocytotic figures were observed in denervated G cells after SV+P which were stimulated by meat extract or insulin hypoglycemia. In Parallel with the electron microscopic observations of G cells, the plasma gastrin levels began to be elevated.

 From these findings, G cells could release gastrin in response to stimulation by meat extract and insulin hypoglycemia of ter the SV -~ P when the antrum is conserved. Then hypergastrinemia occurred due to G cells hyperplasia. So, it is necessary to do complete vagotomy on the parietal cell region in case of SV+P.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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