A 45-year-old man undergoes proximal gastric vagotomy for treatment of intractable duodenal ulceration. What physiologic alterations might be anticipated as a consequence of the operation?

b. Accelerated gastric emptying of liquids

d. Fasting hypergastrinemia

Division of cholinergic vagal fibers directly affects parietal cell acid secretion by reducing stimulatory input. Basal acid secretion is diminished by approximately 80% and maximal acid output in response to pentagastrin stimulation is reduced by about 70%. Fasting hypergastrinemia and an exaggerated gastrin response to meal ingestion is observed due to loss of feedback inhibition of gastrin release and gastrin cell hyperplasia. Release of pancreatic polypeptide, secretin and cholecystokinin may be decreased.

 Proximal gastric vagotomy accelerates gastric emptying of liquids due to a loss of receptive relaxation. In contrast, gastric emptying of solids is usually not affected by proximal gastric vagotomy.