Prolonged gastroplegia after truncal vagotomy

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Prolonged postoperative bowel ileus is a significant complication following abdominal surgery.
• Truncal vagotomy, a procedure to reduce gastric acid, can be associated with delayed gastric emptying.

Purpose of the Study:

• To analyze the clinical and etiopathogenic issues of prolonged postoperative bowel ileus after truncal vagotomy.
• To evaluate management strategies for persistent gastroplegia.

Main Methods:

• Retrospective analysis of 705 truncal vagotomies performed over a 12-year period.
• Identification and characterization of cases with prolonged postoperative bowel ileus and gastroplegia.

Main Results:

• Gastroplegia occurred in 23 cases (3.26%).
• Six patients (0.85%) required reoperation due to gastroplegia persisting for over 20 days.
• Gastric atony management remains variable, with gastric resection and jejunostomy as potential interventions.

Conclusions:

• Prolonged postoperative bowel ileus and gastroplegia are potential complications of truncal vagotomy.
• Management strategies for severe gastroplegia are not standardized and may include gastric resection or jejunostomy.
• Jejunostomy offers a less risky approach for nutritional support while awaiting return of bowel function.