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Out of 400 patients who underwent proximal gastric vagotomy (PGV), three developed lesser-curve necrosis (LCN) leading to perforation within the first seven days. In each case diagnosis was delayed but the patient survived after a second operation. In each an associated Nissen fundoplication had been carried out; we used the combined operation in only 33 patients. Delayed LCN occurred in a patient who had undergone splenectomy at the time of the PGV and in a fifth patient treated elsewhere who had also undergone fundoplication. These findings indicate that early postoperative gastric distension with gas, not readily voided after fundoplication, may aggravate local vascular factors and predispose to LCN. We suggest that PGV combined with fundoplication may be dangerous.
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
November 1975,
British medical journal,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
February 1976,
British medical journal,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
August 1991,
The European journal of surgery = Acta chirurgica,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
January 1979,
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
May 1984,
The Japanese journal of surgery,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
February 1979,
Endoscopy,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
February 1988,
The British journal of surgery,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
February 1979,
Helvetica chirurgica acta,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
July 1991,
Surgery, gynecology & obstetrics,
T Kennedy, and
P Magill, and
G W Johnston, and
T G Parks
August 1985,
World journal of surgery,
