Acid Response to Sham Feeding as a Test for Completeness of Vagotomy

The reproducibility of acid responses to modified sham feeding by the chew-and-spit technique (PAOsh) was investigated in 21 duodenal ulcer (DU) patients 8 to 14 days after vagotomy. Possible relationships between PAOsh and the acid response to 0.2 U of insulin per kilogram body weight were examined (PAOI) in 23 other DU patients 8 to 14 days after vagotomy. PAOsh was reproducible to a high degree (PSpearman less than 0.001, CV 2.9%), and a highly significant relationship was found between PAOsh and PAOI after vagotomy (PSp less than 0.001). PAOsh and PAOI were similar when PAOI was low, whereas a highly incomplete vagotomy according to PAOI was followed by a somewhat lower, but substantial, acid response to sham feeding. The relationship between PAOsh and PAOI permits the recommendation of modified sham feeding as a safe stimulant of acid secretion in quantitative testing of completeness of vagotomy.