Serum group I
pepsinogen (PG I) levels have been determined before and at intervals after the administration of
betazole hydrochloride (
Histalog) in 50 symptomatic postoperative patients, 20 with and 30 without recurrent
ulcer, after either a
vagotomy and gastric resection or a drainage procedure. In patients with recurrent
ulcer, mean serum PG I levels increased after
betazole and reached a maximum of 116.5 +/- 2.2% (SE) of basal at 2 hr; range 98.9 to 135.7%. In contrast, mean serum PG I levels decreased in patients without recurrent
ulcer and reached a nadir of 75.0 +/- 4.3% of basal at 2 hr; range 46.9 to 142.4%. All 20 patients with recurrent
ulcer and 5 patients without recurrence had a 2-hr serum PG I level of more than 98% of basal, while each of the remaining 25 patients without recurrent
ulcer had a 2-hr level of less than 92% of basal. A 2-hr serum PG I level of more than 98% of basal was also correlated with a
vagotomy and drainage, a peak
acid output of more than 11 mEq per hr, and a positive
insulin test, while a level of less than 92% of basal was correlated with a
vagotomy and gastric resection, a peak
acid output of less than 11 mEq per hr, and a negative
insulin test. In addition, basal serum PG I and serum
gastrin levels were significantly higher (P less than 0.001) in patients with the former type of PG I response than in those with the latter type of response. The cause of each type of response is not certain, but the data suggest that one of the determinants may be the completeness of
vagotomy.