Indispensability of Vagal-Antral Rami for Preserving Gastric Motor Function after Vagotomy

Abstract

In cases where vagotomy has been performed as a surgical treatment for gastroduodenal ulcer, postoperative gastric stasis [1] gives rise to distention in the gastrin-secreting area and further to intensification of the humoral acid-secreting mechanism, thus inducing a rise in the gastric acidity and possible recurrence of ulcer after vagotomy. It has been, made clear, however, that total antrectomy [2] combined with selective vagotomy (SV) is capable of achieving thorough post-operative reduction of acidity. On the other hand, selective proximal vagotomy (SPV) [3, 6, 7, 8] has been developed on the basis of the theory that the ability [9] to suppress excessive gastrin is brought into full play while the motor function of emptying is retained. We have already performed this operation clinically in 45 cases and observed that of broad resection may be omitted. Further, we confirmed maintenance of gastric movement and adequate postoperative reduction of acidity. Studies have been made on the relationship between truncal vagotomy (TV) [10] and gastric dyskinesia. However, few experimental reports are available on the relationship between SPV and gastric motility. To investigate this question, the authors made several experiments.