ABSTRACT
The recurrence rate of duodenal ulcer after highly selective vagotomy is nearly 10 percent. To diminish this percentage, extended highly selective vagotomy with sectioning the gastroepiploic nerves has been proposed in order to reduce postoperative gastric acid secretion. We have prospectively compared the decrease in gastric acid secretion through measurement of basal acid output, maximal acid output, and peak acid output in patients who underwent highly selective vagotomy or extended highly selective vagotomy. No significant differences in postoperative gastric acid secretion were found and, therefore, no changes in the probability of postoperative recurrence of duodenal ulcer were seen.
Subject(s)
Duodenal Ulcer/surgery , Gastric Acid/metabolism , Vagotomy, Proximal Gastric , Adolescent , Adult , Duodenal Ulcer/physiopathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Period , Preoperative Care , Prospective Studies , Random AllocationABSTRACT
The results of the present study demonstrate that, at the level of the proximal branch of Crow's foot of Latarjet, parietal cells are found, and therefore, it must be sectioned when performing highly selective vagotomy. At the level of the distal branch, antral mucosa is found. At the level of the middle branch, in almost one-half of the instances, parietal cells are found, and its section must be evaluated with gastric emptying studies.
