Effects of highly selective vagotomy and additional procedures on gastric emptying in patients with obstructing duodenal ulcer

Before being superseded by medical management, highly selective vagotomy (HSV) without drainage was the procedure of choice for uncomplicated duodenal ulcer. It is also justified for complications, including perforation and bleeding in selected cases. This prospective study evaluated the effects of HSV plus drainage on solid gastric emptying in 20 patients with chronic duodenal ulcer and pyloric stenosis. Patients were treated with HSV plus pyloroplasty (Heineke-Mikulicz pyloroplasty in five patients, Finney pyloroplasty in six patients and Jaboulay gastroduodenostomy in nine patients) and underwent solid-phase gastric emptying scintigraphic studies pre-operatively and 2 months and 6 months post-operatively. Results were compared with those from 10 controls. No significant differences were observed between the different types of pyloroplasty, although emptying was slightly faster in the gastroduodenostomy group. Gastric emptying returned to normal by 6 months post-operatively. In conclusion, HSV plus pyloroplasty is effective and can be used for the relief of stenosis in selected cases of duodenal ulcer.

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Bile acid and lysolecithin concentrations in the stomach in patients with duodenal ulcer before operation and after treatment by highly selective vagotomy, partial gastrectomy, or truncal vagotomy and drainage

Gut ◽

10.1136/gut.23.7.569 ◽

1982 ◽

Vol 23 (7) ◽

pp. 569-577 ◽

Cited By ~ 37

Author(s):

P Dewar ◽

R King ◽

D Johnston

Keyword(s):

Duodenal Ulcer ◽

Bile Acid ◽

Partial Gastrectomy ◽

Truncal Vagotomy ◽

Selective Vagotomy ◽

Highly Selective Vagotomy

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Early return to work following highly selective vagotomy

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-76-39 ◽

1990 ◽

Vol 76 (1) ◽

pp. 39-42

Author(s):

D. N. Tulloch ◽

E. P. Dewar

Keyword(s):

Duodenal Ulcer ◽

Ulcer Recurrence ◽

Royal Navy ◽

Selective Vagotomy ◽

Highly Selective Vagotomy ◽

Early Return ◽

The Mean ◽

A Prospective Study ◽

Return To Duty ◽

Mean Time

SummaryIn the Royal Navy, after surgery, the time that servicemen spend away from work and the level of duty to whch they return are decisions made by the surgeon, not the general practitioner.In a prospective study, we have thus been able to assess the acceptability of return to full duty at decreasing intervals after highly selected vagotomy (HSY).Seventy-eight service men who underwent HSY for duodenal ulcer were studied in three periods, 1978–1980, 1981–1982, 1983–1986, each with a shorter interval to return to duty.There were no differences in the rates of ulcer recurrence, incisional hernia, or ability to perform full duties.After HSY the mean time to return to full duties for each group was 29.3, 16.4, and 4.2 weeks, respectively. Every patient returned to full duties at 28 days was able to perform any assigned task whether at sea or ashore.

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