Study on dysphagia after proximal selective vagotomy

The authors examined one of the characteristic complications--dysphagia--of proximal selective vagotomy widely applied in the surgical treatment of duodenal ulcerations. To gain a better knowledge of the causes of this type of complications measuring the pH value for 24 hours and manometric examinations of the lower esophageal sphincter were performed in 12 patients without complaints following operation and in 22 with the complaint of dysphagia. No significant changes were observed between the two groups either in basal sphincter pressure or in the two parameters characteristic for reflux activity, e.g. the number of reflux episodes and reflux index. Operation resulted in a slight increase of the basal pressure and the decrease of reflux activity in both groups. It is likely that postvagotomical dysphagia has a multifactorial background: denervation or mechanical trauma of the lower oesophagus and the uncoordinated and insufficient relaxation of the lower oesophageal sphincter following swallowing.