Results of highly selective vagotomy

Abstract

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Dynamic Visick grading after highly selective vagotomy

“…Such a method of grading is not new [7,10,11,18]. It was presented for the first time by Visick, who applied it on his 500 patients who underwent gastric resection.…”

“…The 262 patients, surgeons, and the operating methods have been described previously (see preceding article by Busman et al) [10,11]. Follow-up examinations and interviews were carried out 6 months and 1 year after operation and yearly thereafter.…”

Recurrence rate after highly selective vagotomy

“…The method of operation has been described before [28,29] and was essentially the technique of Johnston, based on ana- tomical landmarks [40,41]. Initially, however, elements of Goligher's technique were employed, in which the greater curvature was not dissected and the dissection of the lesser curvature started slightly further away from the pylorus (7-8 cm) [42].…”

“…In order to improve the results, attempts were ruade to delineate the surgeon failures and, according to many reports, subsequent improvement of technique diminished the number of failures [8][9][10][11][12][13][14][15][16][17][18][19][20]. The supposed completeness of the vagotomy, however, was not always a guarantee against recurrence [21][22][23][24][25][26], so that it should perhaps be postulated that failures inherent in the method do occur after HSV [27][28][29][30]. Probably all series of HSV's with apparently unavoidable recurrences contain a mixture of method failures and surgeon failures, and these cannot be distinguished with certainty at present.…”