Value of simplified, highly selective transgastric vagotomy in duodenal ulcer surgery

The technique of preservation of the antral vagal nerve supply of the stomach and division of the gastric branches of the nerves of Latarjet remains unchanged. By replacing the transection of th hiatal cardioesophageal vagus nerve branches (including the nerve branches accompanying the arteries entering the fundus of the stomach) with transgastric intramural transection and excision of all nerve fibers entering the fundus, highly superselective vagotomy is achieved. Completeness of this type of vagotomy is controlled intraoperatively by a gastric pH meter and by measuring the oxygen tension of the gastric mucosa. The decrease in oxygen tension of the gastric mucosa below and in the vicinity of the seromuscular incision was similar to that of the rest of the fundus. One year to 18 months after application of highly selective transgastric vagotomy in 74 patients with uncomplicated duocenal ulcers, there was no mortality and insignificant morbidity. The previous ulcer symptoms disappeared. No significant complications such as dumping syndrome or recurrence of ulcer were observed.