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Lower esophageal sphincter function after highly selective vagotomy.

J P Oomen, P Wittebol, W J Geurts

    Archives of Surgery (Chicago, Ill. : 1960)
    |August 1, 1979
    PubMed
    Summary
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    Highly selective vagotomy (HSV) minimally impacts the lower esophageal sphincter (LES). While early changes in LES position occur, they resolve over time, with no significant effect on LES pressure or reflux.

    Area of Science:

    • Gastroenterology and Surgical Research
    • Esophageal Motility and Reflux Studies

    Background:

    • Highly selective vagotomy (HSV) is a surgical procedure affecting the vagus nerve's branches to the stomach.
    • Potential impact of HSV on the functional integrity of the lower esophageal sphincter (LES) requires investigation.

    Purpose of the Study:

    • To evaluate the effects of highly selective vagotomy (HSV) on lower esophageal sphincter (LES) function.
    • To assess changes in LES position relative to the diaphragm, LES pressure, and gastroesophageal reflux patterns post-HSV.

    Main Methods:

    • Manometric studies and 12-hour overnight pH measurements were conducted on 20 patients.
    • Evaluations were performed before, 14 days after, and in five patients, one year after HSV.

    Main Results:

    Related Experiment Videos

    • A transient, slight elongation of the LES was observed early post-HSV, resolving within a year.
    • The pressure inversion point (diaphragm position) descended relative to the LES 14 days post-HSV, with persistent displacement at one year.
    • No significant alterations in LES pressure or an increase in reflux events were detected after HSV.

    Conclusions:

    • Highly selective vagotomy (HSV) does not significantly compromise lower esophageal sphincter (LES) pressure or increase reflux.
    • Transient LES elongation and a persistent shift in the gastroesophageal junction relative to the diaphragm are observed post-HSV.