Plasma Cholecystokinin Response to a Liquid Fat Meal in Vagotomized Patients

Abstract

Since previous studies have suggested that in patients with truncal vagotomy (TV) the plasma cholecystokinin (CCK) secretion in response to nutrients is impaired, the plasma CCK response to a liquid fat meal (250 ml 20% intralipid) was measured in 6 patients with TV and pyloroplasty. The results were compared with those obtained in 8 normal subjects, 6 patients with duodenal ulcer, and 8 patients with highly selective vagotomy (HSV). Plasma CCK concentrations were measured by a sensitive and specific radioimmunoasay employing antibody T204 directed against the sulfated tyrosine region of CCK. Basal plasma CCK concentrations were not significantly different among the 4 groups studied (2.1 .+-. 0.4 pmol/l in normal subjects, 2.8 .+-. 0.5 pmol/l in duodenal ulcer patients, 3.1 .+-. 0.5 pmol/l in patients with TV, and 2.7 .+-. 0.5 pmol/l in patients with HSV). The increments in plasma CCK after ingestion of the fat meal in patients with TV (15.7 .+-. 3.1 pmol/l) and HSV (14.9 .+-. 1.6 pmol/l) were significantly higher (P < 0.01) than those in normal subjects (4.8 .+-. 0.9 pmol/l) and in patients with duodenal ulcer (5.5 .+-. 0.6 pmol/l). Similarly, the integrated plasma CCK secretions in patients with TV (554 .+-. 139 pmol/l, 120 min) and in patients with HSV (876 .+-. 132 pmol/l, 120 min) were significantly increased (P < 0.05) compared to those in normal subjects (187 .+-. 29 pmol/l, 120 min) and in patients with duodenal ulcer (264 .+-. 35 pmol/l, 120 min). Patients with TV and HSV show an increased plasma CCK secretion in response to a liquid test meal.