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A 50-year perspective upon selective gastric vagotomy

P E Donahue¹, C Griffith, H M Richter

¹Division of General Surgery, Cook County Hospital, Chicago, Illinois 60612, USA.

American Journal of Surgery

|July 1, 1996

Summary

Highly selective vagotomy (HSV) is an effective surgical treatment for duodenal ulcers, offering minimal complications and low recurrence rates. This procedure is ideal for most patients, presenting advantages over traditional methods.

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Area of Science:

Gastroenterology
Surgical Innovation
Peptic Ulcer Disease Management

Background:

Postvagotomy complications were initially accepted consequences of duodenal ulcer surgery.
Selective vagotomy procedures aimed to reduce these sequelae.
Highly selective vagotomy (HSV) emerged, preserving antral innervation.

Observation:

HSV adoption varied, with initial US reluctance due to higher recurrence rates compared to vagotomy-antrectomy.
Refinements like extended HSV and pyloric reconstruction improved outcomes.
Current recognition of HSV as a successful operation.

Findings:

HSV is performed with minimal morbidity.
Recurrent ulcer incidence is less than 5%.
Postoperative complications like dumping, diarrhea, and gastric atony are rare.

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Implications:

HSV is considered an ideal procedure for most duodenal ulcer patients.
Earlier surgical intervention for chronic ulcers offers potential advantages.
Contrasts with common US practice of truncal vagotomy with pyloroplasty/resection for urgent cases.