J.Jpn. Surg. Soc.. 83(6): 548-555, 1982
Original article
EFFECTS OF SELECTIVE PROXIMAL VAGOTOMY ON GASTRIC ACID OUTPUT, SERUM GASTRIN RESPONSES TO A TEST MEAL, GASTRIC EMPTYING AND LOWER ESOPHAGEAL SPHINCTER FUNCTION
－With Particular Reference to Postvagotomy Dysphagia－
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Department of Surgery, School of Medicine, Tokai University Kyoji Ogoshi, Hiroyasu Makuuchi, Yasumasa Kondoh, Tomoo Tajima, Toshio Mitomi |
At 12 months after selective proximal vagotomy, significant reduction of gastric acid output was observed both in MAO and insulin-stimulated PAO, but not in BAO. Serum gastrin levels after SPV alone were higher than those obtained after SPV with drainage procedure or selective vagotomy with antrectomy. After SPV alone or SPV with drainage procedure, integrated gastrin responses became increased significantly over those determined preoperatively. Gastric emptying became rapid following SPV with drainage procedure or SV with antrectomy, but not following SPV alone.
Manometric study on the LES demonstrated five abnormal findings after these operative interventions, namely (1) insufficient relaxation after deglutition, (2) abnormal waves such as curling or segmental, (3) elongation of highpressure zone, (4) prolonged reaction time between beginning of deglutition at the esophageal inlet and relaxation of the LES, and (5) disturbed sphincter response to intravenously administered tetra-gastrin.
In our series, there was 65.7% incidence of dysphagia relates closely to direct effects of vagal denervation on the LES mechanism and in some extent to periesophageal inflammation.
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