Prolonged gastroplegia after truncal vagotomy

The authors discuss the clinical and etiopathogenic problems arising from prolonged postoperative bowel ileus on the basis of 705 truncal vagotomies performed over a twelve year basis. Gastroplegia was seen in 23 cases: in six, as it persisted for more than 20 days, a reoperation was necessary. A fixed surgical procedure for this purpose has not yet been established. A wide gastric resection can sometimes resolve gastric atony and its effects, allowing draining of the gastric content by gravity alone. Jejunostomies incur less risk and allow the patient to wait for return of bowel function, and permit basic nutrition to be improved.