Proximal gastric vagotomy: Follow-up at 10–20 years

Abstract

From August 1969 to December 1989, 600 patients had elective proximal gastric vagotomy for duodenal ulceration with an operative mortality of 0.2 per cent. Of these, 372 patients had surgery over 10 years ago. Three hundred and forty-two patients survived for more than 10 years and, in a prospective study, 305 were reviewed, forming the basis of this 10-20-year follow-up report. Forty-six (15 per cent) have had recurrent ulceration; 80 per cent of these developed symptoms within 5 years and no patient has had recurrence after 13 years. Although 29 patients required reoperation for recurrent ulceration, the current patient satisfaction rate for Visick grades I and II is 92 per cent. Only two patients required reoperation because of gastric stasis. It is concluded that proximal gastric vagotomy is a safe and satisfactory first choice operation for duodenal ulceration.

Laparoscopic Highly Selective Vagotomy: Technical Considerations and Preliminary Results in 119 Patients with Duodenal Ulcer or Gastroesophageal Reflux Disease

“…Several authors from Europe and North America, and also we in more than 1200 cases, have shown that it is the operation that best maintains gastric physiology with few side effects and almost no operative mortality [7][8][9][10]. After more than 20 years of its use, the recurrence rate is about 1% each year, with a reduction of peak acid output in around 60% compared to preoperative values [11][12][13].…”

Laparoscopic highly selective vagotomy

“…The dissection is then directed towards the left border of the oesophagus and the angle of His The fat pad of the cardio-oesophageal junction containing the anterior vagus nerve is raised to the right and upwards. At least [5][6] cm of the lower Oesophagus should be skeletonized. After dissection of the neurovascular bundles in the anterior layer of the lesser omentum, it is necessary to dissect the middle part of the lesser omentum.…”

<title>Technique of laparoscopic posterior truncal vagotomy and anterior seromyotomy using endoscopic esophogeal transillumination</title>

“…Concommitently, the aforementioned untoward effects of truncal vagotomies are nearly eliminated (9,10). Recurrence rates of between 5 and 15% are reported in the literature for this procedure (8).…”