Clinical Investigation of Preserving the Right Gastroepiploic Vessel in Selective Vagotomy with Antrectomy

Yozo Watanabe, Hidenori Tsumura, Toshiyuki Nakagawa, Ryoichi Akimoto, Hiroshi Sasaki, Toshio Morimoto, Koichi Sato, Kiyotaka Yabuki*, Takeshi Okubo*, Noburu Sakakibara*

Department of Surgery, Izunagaoka Hospital, Juntendo University School of Medicine
*First Department of Surgery, Juntendo University School of Medicine

We examined the effect of preservation of the right gastroepiploic vessel and concurrent vagal nerve preservation (preservation operation) on the retention of gastric contents after selective vagotomy with antrectomy (SV+A). The subjects were 71 non-preservation operation patients and 25 preservation operation patients in whom SV+A alone was performed for duodenal ulcers. We studied the postoperative course, incidence of gastric retention, the X-ray appearance of the remnant stomach, and gastric exo- and endocrine function. The total rice gruel intake was 67±22% higher for preservation operation patients than for non-preservation operation patients. Gastric retention was noted in 2l.l% of the non-preservation group and 8.3% of the preservation group, and there was a significantly lower rate in the preservation group. The atonic portion of the greater curvature of the remnant stomach shown by gastric fluoroscopy was a maximum of 3.0 cm in the preservation group in the postoperative period, and the tonus of the stomach was thus maintained to a certain extent. Postoperative gastric secretory function showed no difference between the two groups. From these results, it was felt that performing a preservation operation with SV+A was useful in alleviating early postoperative gastric retention.

Key words
selective vagotomy with antrectomy, preservation of the right gastroepiploic vessel, impairment of gastric empting, exo-and endocrine function

Reprint requests
Yozo Watanabe Department of Surgery, Izunagaoka Hospital, Juntendo University School of Medicine
1129 Nagaoka, Izunagaoka-cho, Tagatagun, 410-22 JAPAN

Accepted
April 17, 1991

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