Are bloodflow changes after selective proximal vagotomy responsible for a necrosis in the gastric wall?

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Abstract
Animal experiments were performed to investigate bloodflow distribution before and after selective vagotomy to explain gastric mucosa necrosis found in some patients after vagotomy. Flow measurements were made using the microsphere technique. Changes in the microcirculation were determined under basal and stimulated conditions (250 mg 2-desoxy-D-glucose). After selective vagotomy a reduction in bloodflow of up to 50% could be observed in all layers of the stomach. There were no differences in the bloodflow along either the lesser or greater curvature under basal conditions. In the stimulated stomach, however, the increase in bloodflow along the lesser curvature was higher, although the vessels of this region were mostly altered by SPV operative procedure. From these results it can be concluded that a reduction of arterial input after selective proximal vagotomy is probably compensated for by intramucosal or submucosal anastomoses. Therefore, necrosis in the gastric wall is not due to SPV but probably to other accompanying diseases.

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