Proximal gastric vagotomy: a 7-year review

The records of 31 patients (25 men, 6 women) who had a proximal gastric vagotomy for duodenal ulcer between 1975 and 1981 were reviewed. The mean follow-up was 48 months (range from 9 to 86 months). The mean duration of symptoms was 9 years. Nine patients were treated for bleeding and one had had perforation. In nine patients, concomitant fundoplication was performed and three patients had dilatation of the pylorus. In the postoperative period, nasogastric suction was used for 1 day, full diet was given after 3 days and the hospital stay was 6 days on average. Two patients (6.5%) probably had recurrence, but only one underwent investigation. Postoperative symptoms were generally mild and transient. Two patients described late dumping and four had early satiety. None thought these symptoms were very important. Diarrhea and weight loss were not problems. By a modified Visick grading system, 91% had a result that was satisfactory or better. This study supports the use of proximal gastric vagotomy as the operation of choice for the elective surgical treatment of duodenal ulcer.