J.Jpn. Surg. Soc.. 79(9): 1073-1078, 1978
Report on the annual meeting
RESULTS OF SURGICAL TREATMENT FOR CHRONIC GASTRIC AND DUODENAL ULCERS
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Department of Surgery, School of Medicine Niigata University, Niigata, Japan Terukazu Muto, Hisashi Matsuki, Koichi Nozawa, Seigo Narai, Sadakatsu Tajika, Kazuyoshi Takakuwa, Shigeru Isobe, Hironori Sasaki, Tsutomu Wanifuchi |
As main operative procedures, proximal gastrectomy with selective proximal vagotomy, segmental gastrectomy with selective proximal vagotomy (S + SPV), conventional partial gastrectomy, antrectomy with selective vagotomy and selective proximal vagotomy with or without pyloroplasty (SPV ± P) have been carried out.
The incidence of dumping syndrome, diarrhea and weight-loss was the smallest in the patients who underwent S + SPV and SPV ± P. By the classification of Visick's grading, the patients undergoing S+ SPV showed the best result. The rate of recurrence was 0.5% (5/1,036).
To reduce the rate of recurrence (6.5%) following SPV ± P, newer operative procedure is performing as follows ;
1) Skeletonization of 5-7 cm around abdominal esophagus is performed.
2) On the fornix, two or three pairs of short gastric vessels are dissected.
3) Vagal nerves distributing to posterior wall of the proximal stomach from the splenic artery are dissected.
4) Crow's foot is preserved within 7 cm from pylorus.
5) Vagal nerves around the right gastro-epiploic artery are dissected at the point of 6-7 cm from pylorus.
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