In nine patients, acid titration tests and gastric biopsy specimens were studied before proximal gastric vagotomy (PGV) and 1 week after the operation. When postoperative biopsy specimens were compared with the preoperative ones, no change was found in the thickness of the mucosa. The volume fraction of the mucosa made up of parietal cells was significantly reduced (p less than 0.01) from 13.8% before PGV to 11.2% after PGV (median values). Both before and after the operation, stimulation with pentagastrin was followed by a significant increase in the relative volume of microvilli in parietal cells and a significant reduction of the relative volume of tubulovesicular structures. The magnitude of this ultrastructural response to pentagastrin was similar before and after PGV. The relative volume of lysosome-like structures was significantly increased in parietal cells postoperatively. With this exception, no significant alteration was found when comparing the ultrastructure before and 7 days after PGV.

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