Experimental Studies on Gastric Bypass versus Standard Ulcer Operations

Abstract

Twenty-four mongrel dogs were subjected to one of the following operations: sham (biopsy) operation, two-thirds gastric bypass, two-thirds gastric resection and antrectomy with vagotomy. After three weeks all the dogs were given hist-amine in beeswax injections for a month. Chronic ulcer developed in 50% of dogs with sham operation and 33% of those with antrectomy-vagotomy. None of the dogs with gastric bypass or resection developed chronic ulcer. The frequency of superficial ulcer was least in gastric bypass dogs and largest in antrectomy-vagotomy ones. Gastric mucosal thickness and parietal cell population were significantly increased in histamine-treated dogs with sham or antrectomy-vagotomy operations but not in the proximal stomach of dogs after gastric resection or gastric bypass. The bypassed retained stomach responded to histamine by increased mucosal thickness and parietal cell count. Two-thirds distal gastric bypass with Billroth II type gastroenterostomy is as effective in preventing ulcer as is two-thirds gastric resection. Exclusion procedures are effective in preventing histamine-induced ulcer, if the operations are sufficiently extensive.