Determination of Serum Pepsinogen Group I After Selective Proximal Vagotomy

Levels of serum pepsinogen group I (PGI) and its relationship with gastric output of acid and pepsin were studied, in patients with peptic ulcer and those undergoing selective gastric vagotomy (SPV). 1. In patients with duodenal ulcer (DU) and after SPV, levels of fasting PGI (F-PGI) showed significant positive correlations with levels of acid and pepsin output by tetragastrin stimulation, but not with those by insulin stimulation. 2. Levels of F-PGI in patients with DU and combined peptic ulcer were significantly higher than in healthy individuals and gastric ulcer. 3. Levels of F-PGI and those after insulin stimulation were significantly lower in patients after SPV than in patients with DU. 4. In patients with recurrent DU after SPV, levels of F-PGI, basal acid output (BAO) and basal pepsin output (BPO) were significantly higher than those without recurrence. The probability of DU recurrence would be very high in patients with high levels of PGI (≧70 ng/ml) and/or BAO (≧6.0 mEq/h) and/or BPO (≧100 tyrosine mg/h). From these results, we concluded as belows, 1. The F-PGI would represent gastric output of acid and pepsin by tetragastrin stimulation, and it would be useful as tubeless gastric juice analysis. 2. After SPV, secretion of PGI would be decreased. 3. The level of F-PGI have predictable value of DU recurrence after SPV