Gastric Vagotomy in the Treatment of Peptic Ulcer

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Abstract
A hypersecretion of gastric juice, both in the empty stomach and in response to the stimulus of food-taking, is regularly found in patients with duodenal and gastrojejunal ulcers. When a similar hypersecretion of gastric juice is produced in experimental animals, ulcers will result. Of the total amount of gastric juice produced in 24 hours in normal animals, 45 per cent is due to the nervous phase, 45 per cent to the antral or hormonal phase, and 10 per cent to the intestinal phase of secretory stimulation. In duodenal ulcer patients, the nervous phase of stimulation is enormously exaggerated and may account for 80 per cent of the total acid output of the stomach. This nervous phase of secretion is permanently abolished by a complete supradiaphragmatic vagotomy. This operation is both practical and effective, and the side effects of the procedure can be controlled by a type of postoperative management that is also simple and effective.

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