The effect of vagotomy on the inhibition of gastric secretion by intraduodenal fat

It has been suggested that the inhibition of gastric secretion by intraduodenal fat is a vagal phenomenon in man. Selective and highly selective vagotomy, by preserving this reflex, could offer advantages over truncal vagal section. This paper reports the effect of intraduodenal fat on pentagastrin-stimulated gastric secretion in duodenal ulcer patients before and after truncal vagotomy. Marked inhibition of gastric secretion occurred in all the patients. In the postoperative group gastric secretion was almost totally abolished following fat infusion despite the absence of an abdominal vagal supply. The results suggest that inhibition of gastric secretion by intraduodenal fat is mediated by a nonvagal mechanism in man; from this point of view, therefore, there is little advantage in attempting to preserve the nerve-supply to the duodenum at vagotomy.