A comparison of the Burge and Grassi intraoperative tests for completeness of nerve section in parietal cell vagotomy

Abstract

The Burge and Grassi tests were compared in 22 patients after parietal cell vagotomy. Dissection was continued until the Burge test was negative or until no further nerve fibres could be found. Three Burge-negative patients were Grassi-positive, 2 due to inadequate division of the terminal branches of the nerve of Latarjet at the 'crow's foot' and 1 due to epiploic fibres. One Burge-positive patient was also Grassi-positive but the latter test indicated the position of an undivided oesophageal nerve fibre. It is concluded that the Grassi intraoperative test for completeness of vagotomy is superior to the Burge procedure because it shows how much stomach needs to be vagotomized to denervate the parietal cells and abolish gastric acid secretion and also indicates the position of residual fibres if vagotomy is incomplete.

Denervation of the greater curvature in proximal gastric vagotomy

“…In spite of the small number of recurrences associated with this technique (between 0 and 6%), Reprint requests: Carlos Martinez-Ramos, M.D., C/ Alfar 22 (Aravaca), Madrid-23, Spain. some authors report higher values, even up to 22%, and there is unanimous agreement that incomplete denervation is the principal cause of these ulcer recurrences after PGV [1][2][3].…”