Gastroesophageal reflux is not increased by highly selective vagotomy

In an attempt to determine whether or not highly selective vagotomy leads to increased gastroesophageal reflux, 20 patients were studied after vagotomy (ten underwent highly selective vagotomy and ten, truncal vagotomy and drainage) and ten patients with duodenal ulcer disease were studied preoperatively by history, esophageal manometry, basal pH studies, standard acid reflux tests, acid perfusion tests (Bernstein tests), acid clearance tests and endoscopy with biopsy. Nine of ten patients had either no or minimal reflux symptoms after highly selective vagotomy were contrasted with five of ten preoperative patients who underwent truncal vagotomy and four of ten patients with duodenal ulcer disease. No significant differences in the three patient groups studied were found by esophageal manometry, pH tests, acid perfusion tests, acid clearance tests or endoscopic and histologic examinations. Our results add support to the view that gastroesophageal reflux is not increased after vagotomy (including highly selective vagotomy).