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Vagotomy pp 167-177 | Cite as

Operating Technique of SPV and Pyloroplasty

  • Fritz Holle
  • Sven Andersson

Abstract

The most careful technique is essential SPV = selective proximal vagotomy is an operation which must be conducted with the precision of a neurosurgical technique. The criterion of success is that the patient be insulin-negative, if possible in accordance with 5 criteria (cf. p. 144, fig. 1). This goal was achieved in 3 stages of development.
  1. 1.

    1960 to 1964: SPV of the most important ventral and dorsal branches to the corporal-fundal region was carried out in man similar to “partial vagotomy” in dogs (Griffith and Harkins, 1957). Results: Basal secretion reduced; basal residual acid often remains; stimulated secretion almost unchanged.

     
  2. 2.

    1964 to 1968: SPV extended caudally and cranially up to the angulus and the cardiac crossway. Results: Basal secretion eliminated; stimulated secretion reduced by 30 to 50 %.

     
  3. 3.

    1968 to 1970: SPV completed up to the cranial and caudal borderline nerves; in addition, complete removal of all connections to the His angle: Since 1970 use of intraoperative blue staining (according to LEE) for the preparatory removal of all vagal nerve elements in the subserous layer. Results: Complete elimination of all basal acid, complete insulin negativeness in 2-h tests in 71 % of cases (5 criteria); late-positive 22%; early-positive 7%. Since 1970 the technique has been standardized (cf. fig. 1–5).

     

Keywords

Vagus Nerve Basal Secretion Gastric Plexus Abdominal Esophagus Lateral Crus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Grassi, G., Orecchia, C, Cantarelli, J., Fivoli, E., Sbuelz, B.: Risultati e consideration! sullo studio della secretione gastrica nella malattia ulcerosa in fase operatoria. Chir. Gastroenterologica 3,465 (1969)Google Scholar
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Copyright information

© Springer-Verlag Berlin · Heidelberg 1974

Authors and Affiliations

  • Fritz Holle
    • 1
  • Sven Andersson
    • 2
  1. 1.Chirurg. Poliklinik der Universität8 München 2Germany
  2. 2.Farmakoligska InstitutioneKarolinska InstitutetStockholm 60Sweden

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