Lesser curve superficial seromyotomy--an operation for chronic duodenal ulcer

Lesser curve superficial seromyotomy has been investigated in the dog and in man. The anatomical basis for the operation, which produces an easily performed denervation of the parietal cell mass, is discussed. Acid studies in the dog confirmed that the operation was capable of producing secretory inhibition in keeping with vagotomy of the parietal cell area. A consecutive series of 25 patients with chronic duodenal ulcer has been treated by lesser curve myotomy without a drainage procedure. The operation has the advantages of being easily performed and the risk of damage to the nerve of Latarjet or of ischaemic necrosis of the lesser curvature is obviated. In 20 insulin tests performed within the first month postoperatively all patients have been negative within the first 75 min and there were 4 late positive responses. Early clinical results have been encouraging, there has been no dumping or diarrhoea and all patients are well. It is suggested that further investigation of lesser curve myotomy is warranted.