J.Jpn. Surg. Soc.. 93(9): 1067-1070, 1992

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Report on the annual meeting

PROBLEMS IN ULCER SURGERY AFTER THE INTRODUCTION OF H₂-RECEPTOR ANTAGONISTS

Recently, Antisecretary drugs such as H₂-receptor antagonists (H₂-RA) or proton pump inhibitor have been used for peptic ulcer patients widely in Japan. However, there are possibilities that long term administration of H₂-RA might cause changes in intragastric environment.
The present study was designed to clarify the changes of surgical treatment in Japan Surgical Society training hospitals, before and after introductin of H₂-RA.
Serum gastrin and antral G-cell number was measured after administration of H2-RA (1mg/kg 14 days cotinuous infusion) in rat. Also, acid secretion and gastrin response stimulated by adrenalin (40 ng/kg・min) were measured in duodenal ulcer patients.
1) In the view of surgical treatment, elective operation highly deceased after the introduction of H₂-receptor antagonists, and showed the increase of the rate of emergency operation up to 70%.
2) Hypergastrinemia and antral G cell hyperplasia were observed after administration of H₂-RA in rats.
3) Acid secretion stimulated by adrenalin which is considered as antral G cell dependent, showed a higher response in H₂-RA treated cases than in those untreated.
4) Antrectomy was carried out in 43.4% of the patients treated with H₂-RA versus 18.9% to the patients untreated.

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