Preference for proximal gastric vagotomy combined with cholecystectomy

Abstract

The incidence and severity of postvagotomy diarrhoea has been studied in 32 patients who had undergone both vagotomy and cholecystectomy. Sixteen of these patients had had a proximal gastric vagotomy and 16 a truncal vagotomy and pyloroplasty. Diarrhoea was present in 68 per cent of patients in whom the vagotomy was truncal and in 31 per cent of those in whom it was proximal gastric. Matched groups of patients with truncal vagotomy with pyloroplasty and proximal gastric vagotomy without cholecystectomy were also compared. The possible mechanisms of this diarrhoea following combined vagotomy and cholecystectomy have been discussed.

Highly selective vagotomy combined with cholecystectomy: Is there an increased risk of diarrhea?

“…As opposed to the study [1] that shows an increased risk for diarrhea after truncal vagotomy combined with cholecystectomy, our results do not suggest a similar trend following HSV. Although Clark and associates [2] reported more diarrhea after HSV + C than following HSV alone, their results are based on a very small sample of patients.…”

“…Hence, they suggested that the combination of TV + D and cholecystectomy should be avoided. Clark and colleagues [2] came to similar conclusions concerning the combination of TV + D with cholecystectomy. In addition, they reported a higher incidence of diarrhea after highly selective vagotomy (HSV) with cholecystectomy (HSV + C) than after HSV alone; however, they also noted that diarrhea was significantly more common after TV + D with cholecystectomy than after HSV + C (Table 1).…”