A randomized trial of gastric decompression after truncal vagotomy and anterior pylorectomy

To test the assumption that gastric decompression is beneficial after TV, 66 patients who underwent elective TV plus anterior pylorectomy were randomly allocated into three groups immediately after completing pyloric reconstruction. Patients in group G had a tube gastrostomy, patients in group ND did not have gastric decompression and patients in group NGS were treated with nasogastric suction for 48 to 72 hours. Roentgenographically, greater gastric distension could be noted in patients in the ND group but this was not clinically significant. Patients in the NGS group had a high incidence of mechanical complications, especially when tubes were in place for more than 48 hours. Infections of the chest were not related to gastric decompression techniques. Patients in groups NGS and ND had significantly shorter hospital stays than patients in group G. During the immediate post-operative period after TV, we would recommend no gastric decompression or short term (less than 48 hours) nasogastric suction. Routine gastrostomy is unwarranted.