Experimental Studies Related to Preservation of the Antral Mucosa During Selective Proximal Vagotomy with Mucosal Antrectomy

Takashi Sakakibara

The First Department of Surgery, Juntendo University School of Medicine

Selective proximal vagotomy with mucosal antrectomy (SPV+MA) is known to disturb the function of gastric evacuation due to the performance of an anastomosis near the pyloric ring. To prevent this problem, the antral mucosa should be preserved as much as possible. If too much antral mucosa is preserved, gastric acid output is not reduced. Dogs were used to investigate the interrelation between the preservation of the antral mucosa and gastric acid output, a 1-cm, 2-cm, or 3-cm band of antral mucosa was preserved, and gastric endo-exocrine function and gastric emptying were examined before and after MA as well as SPV+MA. Following SPV+MA with the 3-cm band of antral mucosa preserved from the pyloric ring, there was hypergastrinemia but a sufficient reduction of acid production was noted (MAO: 46.6%; IAO: 90.0%). Furthermore, the evacuation of both liquids and solids was observed to be satisfactory. Therefore, it was concluded that the antral mucosa can be preserved for up to extended 3 cm from the pyloric ring.

Key words
selective proximal vagotomy with mucosal antrectomy, duodenal ulcer surgery, gastric endo-exocrine function, the extent of antral mucosal preservation

Reprint requests
Takashi Sakakibara The First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
October 11, 1990

To read the PDF file you will need Abobe Reader installed on your computer.