-
American Journal of Surgery Feb 1988To stimulate ulcer patients undergoing operation for gastric outlet stenosis, pyloric obstruction was created in dogs and repaired with pyloroplasty to which was added... (Comparative Study)
Comparative Study
To stimulate ulcer patients undergoing operation for gastric outlet stenosis, pyloric obstruction was created in dogs and repaired with pyloroplasty to which was added truncal vagotomy, proximal gastric vagotomy, or no vagotomy. Gastric antral contractile activity after feeding a solid meal was studied before and after repair (2 week period of study). This activity was correlated with the initial lag and regulated phases of solid meal emptying. Five quantified indices of contractile activity measured during the first postprandial hour indicated variable and inconclusive results in the antrum during the lag phase (first 20 minutes). Consistent percentage changes in these indices after obstruction repair were seen during the subsequent regulated phase. Gastric work was reduced 28 to 35 percent, but not work capability (mean area), by pyloric obstruction in the no vagotomy dogs. Reductions seen in proximal gastric vagotomy dogs were not different from those in the no vagotomy dogs. Higher percentages of reduction in amplitude (70 percent) and mean area of contractions (53 percent) occurred after truncal vagotomy compared with what occurred in the no vagotomy dogs. Mean area was also reduced more compared with what occurred in the proximal gastric vagotomy dogs. These data indicate that the reduced gastric work after feeding and impaired work capability caused by truncal vagotomy when superimposed on that produced by pyloric obstruction may exaggerate gastric atony and contribute to the delayed recovery of gastric emptying seen in the clinical setting.
Topics: Animals; Dogs; Food; Gastric Emptying; Gastrointestinal Motility; Pyloric Antrum; Random Allocation; Time Factors; Vagotomy; Vagotomy, Proximal Gastric
PubMed: 3341543
DOI: 10.1016/s0002-9610(88)80693-7 -
Journal de Chirurgie Oct 1983Various new more extensive operative procedures have been proposed with the aim of increasing efficacy of vagotomy and ensuring maximum neurotomy. Though based on the...
Various new more extensive operative procedures have been proposed with the aim of increasing efficacy of vagotomy and ensuring maximum neurotomy. Though based on the principle of neurotomy as accomplished by highly selective vagotomy, it is completed or combined with a seromyotomy along one or both sides of the lesser curvature or with one in the cardiofundal region. Technical aspects of these different methods are discussed.
Topics: Humans; Vagotomy; Vagotomy, Proximal Gastric
PubMed: 6655004
DOI: No ID Found -
Endoscopic Surgery and Allied... Apr 1994Simplified parietal cell vagotomies (Taylor's and Hill-Barker's procedures) were proposed more than a decade ago to make the operation easier and faster. Efficacy and...
Simplified parietal cell vagotomies (Taylor's and Hill-Barker's procedures) were proposed more than a decade ago to make the operation easier and faster. Efficacy and safety have proven to be as good as with proximal gastric vagotomy. The Hill-Barker operation is particularly simplified by the laparoscopic approach, which enables the procedure to be performed very precisely. The limited trauma of minimally invasive vagotomy has increased the interest in peptic ulcer surgery, especially for patients with chronic duodenal ulcer disease who cannot or do not want to take long-term continuous medication, or who are resistant to it. We describe our technique of performing the laparoscopic Hill-Barker procedure. Our initial results with eleven patients show no operative mortality and minimal morbidity with early discharge and ulcer of all patients. Of the 9 cases which are evaluable, 8 are pain-free and one had an ulcer recurrence after incomplete vagotomy.
Topics: Duodenal Ulcer; Follow-Up Studies; Humans; Laparoscopes; Microsurgery; Surgical Equipment; Surgical Instruments; Vagotomy, Proximal Gastric; Vagotomy, Truncal
PubMed: 8081927
DOI: No ID Found -
Archives of Surgery (Chicago, Ill. :... Mar 1980In the 36 years since the reintroduction of truncal vagotomy for the treatment of duodenal ulcer, recurrent ulcer at a rate of between 7% and 12% has become accepted as...
In the 36 years since the reintroduction of truncal vagotomy for the treatment of duodenal ulcer, recurrent ulcer at a rate of between 7% and 12% has become accepted as the most serious long-term postoperative complication. Although techniques for performance of complete vagotomy have been described, many of these principles of technique have been either forgotten or discarded. The new techniques of vagotomy, that is, selective and highly selective vagotomy, have realerted us to the necessity of performing a careful and wide anatomic dissection of all periesophageal tissue of the esophagogastric junction.
Topics: Duodenal Ulcer; Humans; Recurrence; Vagotomy; Vagus Nerve
PubMed: 7356381
DOI: 10.1001/archsurg.1980.01380030020005 -
JAMA Jun 1979
Topics: Deglutition Disorders; Humans; Vagotomy
PubMed: 439308
DOI: No ID Found -
Vestnik Khirurgii Imeni I. I. Grekova Apr 1982
Comparative Study Review
Topics: Biliary Tract Diseases; Drainage; Duodenal Ulcer; Gastrectomy; Humans; Intestine, Small; Intraoperative Complications; Postoperative Complications; Pylorus; Recurrence; Stomach Diseases; Stomach Ulcer; Vagotomy
PubMed: 7048701
DOI: No ID Found -
The American Surgeon Jul 1976The surgical physiology of the vagus is reviewed with respect to vagotomy in the treatment of duodenal ulcer. All types of vagotomy (truncal, selective gastric, or...
The surgical physiology of the vagus is reviewed with respect to vagotomy in the treatment of duodenal ulcer. All types of vagotomy (truncal, selective gastric, or proximal gastric) produce similar reduction in acid secretion and comparable elevation in serum gastrin. The evidence is mounting that the vagus may have opposing influences on gastrin release: stimulation and inhibition. Division of only the extragastric vagal branches leads to withdrawal of an inhibitory mechanism rendering the denervated stomach more sensitive to the action of gastrin. The loss of this vagally controlled inhibitory mechanism, rather than more meticulous dissection, may explain the higher incidence of more complete vagotomies in selective than in truncal vagotomy. Proximal gastric vagotomy may be the ideal elective operation yet devised for duodenal ulcer. It does, however, cause elevation in serum gastrin and more than 90 per cent of patients after this operation will have positive insulin test in two to four years. This is higher than the positivity seen with truncal vagotomy. Results of controlled trials are needed before this operation becomes fully established.
Topics: Animals; Duodenum; Gallbladder; Gastric Juice; Gastric Mucosa; Gastrins; Humans; Hypoglycemia; Liver; Neural Inhibition; Pancreatic Juice; Peptic Ulcer; Stomach; Vagotomy; Vagus Nerve
PubMed: 937859
DOI: No ID Found -
Zeitschrift Fur Gastroenterologie.... Apr 1982
Topics: Diarrhea; Dumping Syndrome; Gastrectomy; Gastric Emptying; Humans; Peptic Ulcer; Recurrence; Vagotomy; Vagotomy, Proximal Gastric
PubMed: 6191464
DOI: No ID Found -
Actualites Hepato-gastro-enterologiques 1965
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Vagotomy
PubMed: 5875085
DOI: No ID Found -
Minerva Medica Nov 1971
Topics: Humans; Postoperative Complications; Vagotomy
PubMed: 5130755
DOI: No ID Found