[Extended superselective vagotomy. Experimental bases and application in the surgical treatment of duodenal ulcer]

There is a sound basis for performing EHSV with reference to the "areas of vagotomy" as described and for wider application of EHSV. Most patients with complications of duodenal ulcer disease can be treated successfully by EHSV, with a small incidence of recurrent ulcers. The liberal use of pyloroplasty or drainage procedures is justified, since the potential problems of perioperative infection and postoperative alkaline reflux are not clinically significant. Post-gastrectomy syndromes can be largely avoided if gastric resection is reserved only for the few patients with deep ulcers of the lesser curvature. Intraoperative testing for completeness of vagotomy is a useful adjunct in the performance of EHSV, especially by those who are learning the technique. If the principles of EHSV are followed, routine use of intraoperative testing is superflous.