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. 1974 Jul;15(7):521–525. doi: 10.1136/gut.15.7.521

Faecal fat excretion after truncal, selective, and highly selective vagotomy for duodenal ulcer

J P Edwards, P J Lyndon, R B Smith, D Johnston
PMCID: PMC1412969  PMID: 4430470

Abstract

Faecal fat excretion was measured on a metabolic ward in 16 patients with duodenal ulcer before operation, and in patients who were in good health more than one year after truncal vagotomy and pyloroplasty (n = 11), bilateral selective vagotomy and pyloroplasty (n = 9), or highly selective vagotomy without a drainage procedure (HSV, n = 12). Excretion of faecal fat was significantly greater (p < 0·01) in patients after both truncal and selective vagotomy with drainage than in patients before operation. Fat excretion in HSV patients was little different from that of preoperative patients.

If steatorrhoea is defined as a faecal fat output of more than 6 g per day, one of 16 preoperative patients with duodenal ulcer (6%) had steatorrhoea, one of 12 HSV patients (8%) had steatorrhoea, one of nine patients after selective vagotomy and pyloroplasty (11%) had steatorrhoea but five of 11 patients after truncal vagotomy and pyloroplasty (45%) had steatorrhoea.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amdrup E., Jensen H. E. One hundred patients five years after selective gastric vagotomy and drainage for duodenal ulcer. Surgery. 1973 Sep;74(3):321–325. [PubMed] [Google Scholar]
  2. BALDWIN J. N., ALBO R., JAFFE B., SILEN W. METABOLIC EFFECTS OF SELECTIVE AND TOTAL VAGOTOMY. Surg Gynecol Obstet. 1965 Apr;120:777–783. [PubMed] [Google Scholar]
  3. BUTLER T. J., EASTHAM R. D. ABSORPTION STUDIES AFTER GASTROJEJUNOSTOMY WITH AND WITHOUT VAGOTOMY. Gut. 1965 Feb;6:69–72. doi: 10.1136/gut.6.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. COX A. G., BOND M. R., PODMORE D. A., ROSE D. P. ASPECTS OF NUTRITION AFTER VAGOTOMY AND GASTROJEJUNOSTOMY. Br Med J. 1964 Feb 22;1(5381):465–469. doi: 10.1136/bmj.1.5381.465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Carlson H. C., Code C. F., Nelson R. A. Motor action of the canine gastroduodenal junction: a cineradiographic, pressure, and electric study. Am J Dig Dis. 1966 Feb;11(2):155–172. doi: 10.1007/BF02239239. [DOI] [PubMed] [Google Scholar]
  6. Clarke R. J., Alexander-Williams J. The effect of preserving antral innervation and of a pyloroplasty on gastric emptying after vagotomy in man. Gut. 1973 Apr;14(4):300–307. doi: 10.1136/gut.14.4.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Clarke R. J., McFarland J. B., Williams J. A. Gastric stasis and gastric ulcer after selective vagotomy without a drainage procedure. Br Med J. 1972 Feb 26;1(5799):538–539. doi: 10.1136/bmj.1.5799.538. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Colmer M. R., Owen G. M., Shields R. Pattern of gastric emptying after vagotomy and pyloroplasty. Br Med J. 1973 May 26;2(5864):448–450. doi: 10.1136/bmj.2.5864.448. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. DREILING D. A., DRUCKERMAN L. J., HOLLANDER F. The effect of complete vagisection and vagal stimulation on pancreatic secretion in man. Gastroenterology. 1952 Apr;20(4):578–586. [PubMed] [Google Scholar]
  10. De Miguel J. Diarrea tras diversas formas de vagotomía con y sin drenage complementario. Rev Esp Enferm Apar Dig. 1972 Nov 1;38(5):595–600. [PubMed] [Google Scholar]
  11. Dellipiani W., Macleod I. B., Thomson J. W., Shivas A. A. Gastroenterostomy and vagotomy for chronic duodenal ulcer. Gut. 1969 May;10(5):366–374. doi: 10.1136/gut.10.5.366. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Dozois R. R., Kelly K. A., Code C. F. Effect of distal antrectomy on gastric emptying of liquids and solids. Gastroenterology. 1971 Nov;61(5):675–681. [PubMed] [Google Scholar]
  13. Fields M., Duthie H. L. Effect of vagotomy on intraluminal digestion of fat in man. Gut. 1965 Jun;6(3):301–310. doi: 10.1136/gut.6.3.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Goligher J. C., Pulvertaft C. N., De Dombal F. T., Conyers J. H., Duthie H. L., Feather D. B., Latchmore A. J., Shoesmith J. H., Smiddy F. G., Willson-Pepper J. Five to eight-year results of Leeds-York controlled trial of elective surgery for duodenal ulcer. Br Med J. 1968 Jun 29;2(5608):781–787. doi: 10.1136/bmj.2.5608.781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Goligher J. C., Pulvertaft C. N., Irvin T. T., Johnston D., Walder B., Hall R. A., Willson-Pepper J., Matheson T. S. Five- to eight-year results of truncal vagotomy and pyloroplasty for duodenal ulcer. Br Med J. 1972 Jan 1;1(5791):7–13. doi: 10.1136/bmj.1.5791.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Humphrey C. S., Johnston D., Walker B. E., Pulvertaft C. N., Goligher J. C. Incidence of dumping after truncal and selective vagotomy with pyloroplasty and highly selective vagotomy without drainage procedure. Br Med J. 1972 Sep 30;3(5830):785–788. doi: 10.1136/bmj.3.5830.785. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Humphrey C. S., Wilkinson A. R. The value of preserving the pylorus in the surgery of duodenal ulcer. Br J Surg. 1972 Oct;59(10):779–783. doi: 10.1002/bjs.1800591009. [DOI] [PubMed] [Google Scholar]
  18. Johnston D., Humphrey C. S., Walker B. E., Pulvertaft C. N., Goligher J. C. Vagotomy without diarrhoea. Br Med J. 1972 Sep 30;3(5830):788–790. doi: 10.1136/bmj.3.5830.788. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. KRAFT R. O., KIRSH M. M., KITTLESON A. C., ERNST C. B., POLLARD H. M., RANSOM H. K. METABOLIC STUDIES IN PATIENTS SUBSEQUENT TO SELECTIVE GASTRIC VAGOTOMY. Surg Gynecol Obstet. 1965 Mar;120:472–474. [PubMed] [Google Scholar]
  20. LOGAN H. STEATORRHOEA AND DIARRHOEA AFTER VAGOTOMY: A COMPARISON OF DRAINAGE PROCEDURES. Gut. 1964 Apr;5:188–191. doi: 10.1136/gut.5.2.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. McKelvey S. T. Gastric incontinence and post-vagotomy diarrhoea. Br J Surg. 1970 Oct;57(10):741–747. doi: 10.1002/bjs.1800571012. [DOI] [PubMed] [Google Scholar]
  22. McKelvey S. T., Toner D., Connell A. M., Kennedy T. L. Coeliac and hepatic nerve function following selective vagotomy. Br J Surg. 1973 Mar;60(3):219–221. doi: 10.1002/bjs.1800600314. [DOI] [PubMed] [Google Scholar]
  23. Novis B. H., Bank S., Marks I. N. The cephalic phase of pancreatic secretion in man. Scand J Gastroenterol. 1971;6(5):417–422. doi: 10.3109/00365527109180719. [DOI] [PubMed] [Google Scholar]
  24. PFEFFER R. B., STEPHENSON H. E., HINTON J. W. The effect of thoracolumbar sympathectomy and vagus resection on pancreatic function in man. Ann Surg. 1952 Oct;136(4):585–594. [PMC free article] [PubMed] [Google Scholar]
  25. Payne R. A., Wighton R., Bluhm M. Evaluation of drainage procedures combined with vagotomy. Proc R Soc Med. 1970 Sep;63(9):941–943. doi: 10.1177/003591577006300934. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sarles H., Dani R., Prezelin G., Souville C., Figarella C. Cephalic phase of pancreatic secretion in man. Gut. 1968 Apr;9(2):214–221. doi: 10.1136/gut.9.2.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Shina E., Griffith C. A. Selective and total vagotomy without drainage: a comparative study of gastric secretion and motility in dogs. Ann Surg. 1969 Mar;169(3):326–333. doi: 10.1097/00000658-196903000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Smith R. B., Edwards J. P., Johnston D. Does the vagal nerve-supply to the pancreas matter in man? Br J Surg. 1973 Apr;60(4):318–318. [PubMed] [Google Scholar]
  29. Walker B. E., Kelleher J., Davies T., Smith C. L., Losowsky M. S. Influence of dietary fat on fecal fat. Gastroenterology. 1973 Feb;64(2):233–239. [PubMed] [Google Scholar]
  30. Wastell C., Ellis H. Faecal fat excretion and stool colour after vagotomy and pyloroplasty. Br Med J. 1966 May 14;1(5497):1194–1197. doi: 10.1136/bmj.1.5497.1194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Wheldon E. J., Venables C. W., Johnston I. D. Late metabolic sequelae of vagotomy and gastroenterostomy. Lancet. 1970 Feb 28;1(7644):437–440. doi: 10.1016/s0140-6736(70)90831-7. [DOI] [PubMed] [Google Scholar]
  32. Wilbur B. G., Kelly K. A. Effect of proximal gastric, complete gastric, and truncal vagotomy on canine gastric electric activity, motility, and emptying. Ann Surg. 1973 Sep;178(3):295–303. doi: 10.1097/00000658-197309000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Wilkinson A. R., Johnston D. Effect of truncal, selective and highly selective vagotomy on gastric emptying and intestinal transit of a food-barium meal in man. Ann Surg. 1973 Aug;178(2):190–193. doi: 10.1097/00000658-197308000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Wilkinson R. Polyethylene glycol 4000 as a continuously administered non-absorbable faecal marker for metabolic balance studies in human subjects. Gut. 1971 Aug;12(8):654–660. doi: 10.1136/gut.12.8.654. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Williams E. J., Irvine W. T. Functional and metabolic effects of total and selective vagotomy. Lancet. 1966 May 14;1(7446):1053–1057. doi: 10.1016/s0140-6736(66)91006-3. [DOI] [PubMed] [Google Scholar]

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