AN EVALUATION OF HIGHLY SELECTIVE VAGOTOMY IN THE TREATMENT OF CHRONIC DUODENAL-ULCER

  • 1 January 1980
    • journal article
    • research article
    • Vol. 150  (6) , 845-849
Abstract
A randomized trial of highly selective vagotomy against truncal vagotomy and gastroenterostomy was performed. Forty patients were analyzed. All operations were performed by 1 surgeon with previous experience with highly selective vagotomy. Comparisons during the operation indicated that highly selective vagotomy took longer to perform and had a greater associated blood loss. Patients with highly selective vagotomy recovery more rapidly after operation as the duration of ileus postoperatively was shorter. Both operations effectively reduced basal and insulin-stimulated peak acid outputs. At the time of follow-up study, at 6 wk and 6 mo. postoperatively, patients with highly selective vagotomy had significantly better overall Visick gradings and had better gradings for the symptom of diarrhea. The differences between the 2 groups gradually diminished after a year, although diarrhea remained significantly worse in patients who had truncal vagotomy. There were no recurrences of ulcer in either group up to 1 yr postoperatively. Highly selective vagotomy has significant advantages over truncal vagotomy and gastroenterostomy in the immediately postoperative period and up to 1 yr after operation. Only a marked increase in bad results from highly selective vagotomy after a year could justify the continued use of truncal vagotomy and gastroenterostomy.

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