[Anatomic pitfalls of vagotomies]

In order to minimise relapses and functional problems after vagotomies, an anatomic study of the vagus nerve at the base of the esophagus and stomach was carried out. Fifty stomachs of adult black African corpses were collected, placed in a formaldehyde solution and then dissected. At the level of the esophageal hiatus, the trunks of the vagus nerve were found in 46% of the cases for the anterior vagus and 24% for the posterior. At the level of the abdominal esophagus there was a single anterior vagus in 68% of cases and single posterior vagus in 64% of cases. At the level of the greater curvature, a recurrent anterior branch was found. At the level of the lesser curvature, the main nerves had a plexiform appearance in 8% of cases for the anterior nerve and 6% of cases for the posterior nerve. The classical arrangement was found in 60% of cases for the main anterior nerve and 64% of the cases for the posterior nerve. At the level of the angulus, the classical crowsfeet was found in 20% of cases for the anterior vagus and in 32% of cases for the posterior vagus. The anterior vagus was plexiform in 54% of cases and 46% of cases for the posterior. This study confirms the extreme variability of the vagus in the stomach. A better knowledge of the variations should lead to more successful vagotomy regardless of its forms.