The Effect of Gastrin, Secretin and Prostaglandin F2 Alpha on the Lower Esophageal Sphincter of Dogs After Nissen Fundoplication

The effect of gastrin, secretin and prostaglandin F2 alpha on the canine lower esophageal sphincter (LES) after Nissen fundoplication was investigated by esophageal manometry. The gastrin-stimulated LES pressure was significantly higher intraoperatively 2 and 4 weeks after operation than the preoperative stimulation pressure. On the other hand, the prostaglandin F2 alpha-stimulated LES pressure 2 weeks after operation did not differ significantly from the preoperative stimulation value. At 2 weeks after Nissen fundoplication the LES pressure before secretin injection was significantly higher than the preoperative value. However, the LES pressure after secretin injection did not differ significantly from the preoperative stimulation pressure. Therefore, it seems that exogenously administered gastrin, unlike prostaglandin F2 alpha, stimulates the antireflux mechanism after wrapping of the gastric fundus in the Nissen procedure. It was suggested that secretin reacts against the new muscular sphincter substitute created by wrapping of the gastric fundus in the Nissen procedure.