Treatment of severe side effects after vagotomy and gastroenterostomy by closure of gastroenterostomy without pyloroplasty. 1978

M J McMahon, and D Johnston, and G L Hill, and J C Goligher

We describe nine patients who had severe, persistent abdominal pain, vomiting, dumping, or diarrhoea several years after truncal vagotomy and gastroenterostomy had been performed for duodenal ulceration. Each patient was judged to have a bad clinical result (Visick grade 4). There was no evidence of recurrent ulceration in any of the patients, and in each the patency of the pyloric canal was confirmed radiologically or endoscopically. Each patient was treated by simply dismantling the gastroenterostomy without addition for a pyloroplasty. In one patient the surgeon suspected that a vagal trunk might have been left intact, and a revagotomy was performed by the "highly selective" technique. Postoperatively, none of the patients developed gastric retention. Symptomatic improvement occurred in eight patients, and four of them achieved perfect results (Visick grade 1). Side effects are common after vagotomy and gastroenterostomy, and are largely attributable to the presence of the gastroenterostomy stoma. Our results show that the symptoms may be alleviated by closing the gastroenterostomy, without precipitating gastric retention.

UI MeSH Term Description Entries
D008297 Male Males
D004377 Dumping Syndrome Gastrointestinal symptoms resulting from an absent or nonfunctioning pylorus. Dumping Syndromes,Syndrome, Dumping,Syndromes, Dumping
D005260 Female Females
D005746 Gastric Emptying The evacuation of food from the stomach into the duodenum. Emptying, Gastric,Emptyings, Gastric,Gastric Emptyings
D005763 Gastroenterostomy A variety of surgical reconstructive procedures devised to restore gastrointestinal continuity, The two major classes of reconstruction are the Billroth I (gastroduodenostomy) and Billroth II (gastrojejunostomy) procedures. Billroth I,Billroth I Operation,Billroth I Procedure,Billroth II,Billroth II Operation,Billroth II Procedure,Gastroenterostomies,Operation, Billroth I,Operation, Billroth II,Procedure, Billroth I,Procedure, Billroth II
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013272 Stomach Diseases Pathological processes involving the STOMACH. Gastric Diseases,Disease, Gastric,Disease, Stomach,Diseases, Gastric,Diseases, Stomach,Gastric Disease,Stomach Disease
D014628 Vagotomy The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. Vagotomies

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