Abstract
Branches of the nerve of Latarjet run with the serosa of the stomach before penetrating the muscularis. Myotomy of the pylorus and esophagus are safe and well established procedures. Myotomy of the lesser curve of the stomach with preservation of the major vessels should denervate the parietal cell mass; this procedure has been investigated in the dog. Pre- and postoperative secretory stimulation was carried out with pentagastrin (0.375--6 micrograms/kg/hr i.v.) and insulin (0.2 units/kg). After myotomy, in response to pentagastrin, there was a marked shift to the right of the dose response curve of acid secretion and a profound inhibition of pepsin output. The insulin response in terms of acid and pepsin secretion was almost completely abolished. Secretory inhibition after lesser curve myotomy is similar so that produced by proximal gastric vagotomy. These results would appear to give the operation a sound anatomic and physiologic basis for it is not difficult to perform technically and obviates the risk of damage to the nerve of Latarjet of ischemic necrosis of the lesser curvature.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Amdrup B. M., Griffih C. A. Selective vagotomy of the parietal cell mass: Part I: With preservation of the innervated antrum and pylorus. Ann Surg. 1969 Aug;170(2):207–214. doi: 10.1097/00000658-196908000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Amdrup E., Jensen H. E. Selective vagotomy of the parietal cell mass preserving innervation of the undrained antrum. A preliminary report of results in patients with duodenal ulcer. Gastroenterology. 1970 Oct;59(4):522–527. [PubMed] [Google Scholar]
- Barabas A. P., Payne R. A., Johnston I. D., Burns G. P. The effect of vagotomy on gastrin-stimulated gastric-acid secretion in man. Lancet. 1966 Jan 15;1(7429):118–119. doi: 10.1016/s0140-6736(66)91258-x. [DOI] [PubMed] [Google Scholar]
- Basso N., Umeda N., Roth J. L., Passaro E., Jr, Pfeiffer C. J. Effect of unilateral vagotomy on gastric secretion in the ferret. Gastroenterology. 1971 Aug;61(2):207–212. [PubMed] [Google Scholar]
- Dorricott N. J., Mcneish A. R., Alexander-Williams J., Royston C. M., Cooke W. M., Spencer C. J., De Vries B. C., Muller H. Prospective randomized multicentre trial of proximal gastric vagotomy or truncal vagotomy and antrectomy for chronic duodenal ulcer: interim results. Br J Surg. 1978 Mar;65(3):152–154. doi: 10.1002/bjs.1800650303. [DOI] [PubMed] [Google Scholar]
- Dozois R. R., Kirkpatrick J. R. Effect of partial and total vagotomy on the gastric acid response to an insulin infusion in the dog. Ann Surg. 1974 Jan;179(1):12–16. doi: 10.1097/00000658-197401000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Emås S., Grossman M. I. Effect of truncal vagotomy on acid and pepsin responses to histamine and gastrin in dogs. Am J Physiol. 1967 May;212(5):1007–1012. doi: 10.1152/ajplegacy.1967.212.5.1007. [DOI] [PubMed] [Google Scholar]
- GILLESPIE I. E., CLARK D. H., KAY A. W., TANKEL H. I. Effect of antrectomy, vagotomy with gastrojejunostomy, and antrectomy with vagotomy on the spontaneous and maximal gastric acid output in man. Gastroenterology. 1960 Mar;38:361–367. [PubMed] [Google Scholar]
- GRIFFITH C. A., HARKINS H. N. Partial gastric vagotomy: an experimental study. Gastroenterology. 1957 Jan;32(1):96–102. [PubMed] [Google Scholar]
- Goligher J. C., Hill G. L., Kenny T. E., Nutter E. Proximal gastric vagotomy without drainage for duodenal ulcer: results after 5-8 years. Br J Surg. 1978 Mar;65(3):145–151. doi: 10.1002/bjs.1800650302. [DOI] [PubMed] [Google Scholar]
- Hirschowitz B. I., Hutchison G. A. Long-term effects of highly selective vagotomy (HSV) in dogs on acid and pepsin secretion. Am J Dig Dis. 1977 Feb;22(2):81–95. doi: 10.1007/BF01072948. [DOI] [PubMed] [Google Scholar]
- Hunt J. N. A method for estimating peptic activity in gastric contents. Biochem J. 1948;42(1):104–109. doi: 10.1042/bj0420104. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnston D. Operative mortality and postoperative morbidity of highly selective vagotomy. Br Med J. 1975 Dec 6;4(5996):545–547. doi: 10.1136/bmj.4.5996.545. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnston D., Wilkinson A. R. Highly selective vagotomy without a drainage procedure in the treatment of duodenal ulcer. Br J Surg. 1970 Apr;57(4):289–296. doi: 10.1002/bjs.1800570414. [DOI] [PubMed] [Google Scholar]
- McCrea E. D. The Abdominal Distribution of the Vagus. J Anat. 1924 Oct;59(Pt 1):18–40. [PMC free article] [PubMed] [Google Scholar]
- Mitchell G. A. A macroscopic study of the nerve supply of the stomach. J Anat. 1940 Oct;75(Pt 1):50–63. [PMC free article] [PubMed] [Google Scholar]
- Pritchard G. R., Griffith C. A., Harkins H. N. A physiologic demonstration of the anatomic distribution of the vagal system to the stomach. Surg Gynecol Obstet. 1968 Apr;126(4):791–798. [PubMed] [Google Scholar]
- Rivilis J. Collateral nerve sprouting and gastric secretory recovery. Surg Forum. 1969;20:317–319. [PubMed] [Google Scholar]
- Stening G. F., Grossman M. I. Effect of partial vagotomy in the neck or lower thorax on insulin-stimulated acid secretion in dogs. Gastroenterology. 1970 Sep;59(3):376–379. [PubMed] [Google Scholar]
- Taylor T. V. Lesser curve superficial seromyotomy--an operation for chronic duodenal ulcer. Br J Surg. 1979 Oct;66(10):733–737. doi: 10.1002/bjs.1800661016. [DOI] [PubMed] [Google Scholar]
