Serum Pepsinogen I, Serum Gastrin, and Gastric Acid Output in Postoperative Recurrent Peptic Ulcer

• Basal and betazole-stimulated serum pepsinogen I (PG I) levels were measured by radioimmunoassay in 40 patients with recurrent ulcer and in 73 symptomatic patients without recurrence. Basal serum gastrin level and basal and betazolestimulated acid outputs were also determined. For each of these tests, the difference between the mean values for ulcer and nonulcer patients was significant after vagotomy combined with resection (P<.01). The same was true after subtotal gastrectomy (P<.01) with the exception of the basal serum gastrin level (P>.05). After vagotomy and drainage, however, only the mean betazole-stimulated PG I response was different between ulcer and nonulcer patients (P<.05). In the identification of ulcer recurrence, the radioimmunoassay for serum PG I levels is at least as useful as acid secretory tests and is superior to the basal serum gastrin level. (Arch Surg113:1136-1141, 1978)