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Humoral Basis for Gastric Hypersecretion After Portacaval Shunting

Ward O. Griffen Jr., MD; Aldo R. Castaneda, MD
JAMA. 1965;192(5):374-376. doi:10.1001/jama.1965.03080180032007.
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Is the evidence conclusive that gastric hypersecretion following portacaval shunting is of a humoral nature? Experimental data so far supports this concept, but definite proof is still lacking. Gastric hypersecretion from vagally-denervated pouches in dogs with portacaval shunts can be explained by at least two factors other than a humoral mechanism: (1) Heidenhain pouches retain sympathetic innervation which may be an efferent pathway for a stimulating factor; (2) the venousdrainage of these pouches, an integral part of the portal venous system, by changing blood flow rate following portacaval shunting, may induce changes in their secretory pattern.

These two factors are eliminated by transplanting vagally-denervated pouches into the abdominal wall. When the original neurovascular pedicle to the pouch is transected, the sympathetic pathway is interrupted and the venous drainage of the pouch is completely independent of the portal venous system. This report presents the secretory data for such pouches before and


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