An evaluation of the relative utility of different criteria of positivity in assessing the response to insulin induced hypoglycemic stimulation of the vagus as test for completeness of vagotomy.

This study evaluates the relative merits of the five most commonly used criteria for interpreting the results of the insulin test for completeness of vagotomy. One hundred and eighty tests were performed in normal controls and in patients with duodenal ulcer studied both preoperatively and after truncal vagotomy and drainage. It was found that Hollander's original criteria especially the response in the first post insulin hour was more useful than other criteria. Further use of multiple criteria instead of one alone, has a greater predictive value than mere statement of a positive or negative Hollander response.