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

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The addition of cholecystectomy to truncal vagotomy and a drainage procedure increases the incidence and severity of postvagotomy diarrhea. This study attempts to establish whether diarrhea is more common after highly selective vagotomy (HSV) and cholecystectomy than after HSV alone. The incidence of diarrhea in 729 patients who underwent HSV without cholecystectomy was found to be 8.8% whereas, in 66 patients in whom HSV was combined with cholecystectomy, the incidence of diarrhea was 9.3%. In most patients, the diarrhea was very mild and in none was it severe. We conclude that the addition of cholecystectomy to HSV does not result in an increased incidence of diarrhea.


Une cholécystectomie pratiquée en même temps qu'une vagotomie tronculaire augmente la fréquence et la sévérité de la diarrhée post-vagotomie. Le but de cette étude a été de déterminer si la diarrhée était plus fréquente après vagotomie ultrasélective (VUS) associée à une cholécystectomie qu'après VUS seule. L'incidence de diarrhée chez 729 patients ayant subi une VUS sans cholécystectomie était de 8.8% alors que celle des patients ayant subi une VUS avec cholécystectomie était de 9.3%. Chez la plupart des patients, la diarrhée était peu importante, et aucun n'a présenté de diarrhée sévère. Nous concluons que l'adjonction d'une cholécystectomie à une VUS n'augmente pas l'incidence de diarrhée.


Se ha informado que la adición de colecistectomía a la vagotomía troncular con drenaje aumenta la incidencia y severidad de la diarrea postvagotomía. El presente estudio trata de establecer si la diarrea es más frecuente después de vagotomía altamente selectiva (VAS) y colecistectomía que de VAS sola. La incidencia de diarrea en 729 pacientes sometidos a VAS sin colecistectomía fue de 8.8%, en tanto que en 66 pacientes sometidos a VAS combinada con colecistectomía fue de 9.3%. En la mayoría de los casos la diarrea fue muy leve y en ninguno llegó a ser severa. Nuestra conclusión es que la adición de colecistectomía a la VAS no resulta en un incremento en la incidencia de diarrea.

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Author information

Correspondence to Mr. Moshe Schein F.C.S.(S.A.).

Additional information

This study was performed at the University Department of Surgery, The General Infirmary, Leeds, England, United Kingdom.

The author was the recipient of the J. & M. Miller travelling fellowship from the Department of Surgery, University of the Witwatersrand.

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Schein, M. Highly selective vagotomy combined with cholecystectomy: Is there an increased risk of diarrhea?. World J. Surg. 13, 782–784 (1989).

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  • Public Health
  • Diarrhea
  • Cardiac Surgery
  • Abdominal Surgery
  • Vascular Surgery