The effect of extrinsic denervation of the lower part of the esophagus on resting and cholinergic stimulated gastroesophageal sphincter in man
Csendes, A.; Oster, M.; Møller, J.; Brandsborg, O.; Brandsborg, M.; Amdrup, E.
Surgery Gynecology and Obstetrics 148(3): 375-379
1979
ISSN/ISBN: 0039-6087 PMID: 419437 Document Number: 153247
Patients [12] with duodenal ulcers were randomly studied 1 wk before and 1 and 12 wk after operation. Seven patients underwent parietal cell vagotomy and 5 selective gastric vagotomy with drainage. Resting gastroesophageal sphincter pressure and serum gastrin concentrations were measured. The response of gastroesophageal sphincter pressure to 2 or 4 .mu.g per kg body wt of carbacholine was determined every 10 min for 90 min after the subcutaneous injection. There was no significant change in resting gastroesophageal sphincter pressure when parietal cell vagotomy or selective gastric vagotomy was performed. The response of gastroesophageal sphincter pressure to the cholinergic drug was dose dependent before and after the operation. In all patients, a depressed response to carbacholine was observed 1 wk postoperatively, which was restored to normal preoperative values 12 wk after the operation. Three patients had a transient low dysphagia commencing 1 wk after surgical treatment which disappeared in 2 mo. Sphincter relaxation reached fundic pressure in all patients. Resting intraesophageal pressure was negative, and no change in the peristaltic waves of the distal part of the esophagus was recorded. The basal serum gastrin level was higher postoperatively in every instance, and no correlation with resting gastroesophageal sphincter pressure was found. Transient postoperative dysphagia is not due to denervation but most probably due to mechanical factors.