J.Jpn. Surg. Soc.. 79(9): 1079-1083, 1978

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Report on the annual meeting

TRUNCAL VAGOTOMY, ANTERIOR PEXY WITH PYLOROPLASTY FOR DUODENAL ULCER PATIENTS

Truncal vagotomy with drainage procedure for duodenal ulcer patients has been performed in five hundred and ninty cases since 1965. Three hundred and forty-three cases were operated due to intractability, and two hundred and forty-seven cases were emergency including 100 hemorrhage, 68 perforation and 79 pyloric stenosis. The operative mortality was 0.6% in elective operation and 0.4% in emergency operation. The follow-up result grading by Visik's classification shows 39% in group I, 54% in II, 8% in III and none in IV. Recurrence rate was 2.6% and none of them required reoperation. Dumping was in 32%, and diarrhoea was in 28%, however, both were slightly or moderate and there was no severe case.
The low mortality and recurrence rate is obtained by the completeness of gastric vagotomy and enough drainage of gastric content. Use of the Vagal Dissector, Neurostain, Ope-pack and electric knife might contribute to the performance of complete vagotomy. The gastric anterior pexy, proper selection of drainage procedures (Jaboulay, Finney, Heineke-Miculicz) might contribute to enough drainage. Technical precision is strongly required at operation as well as precise knowledge of the vagal anatomy. Devices in the operation were stressed.

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