Comparison of the Effect of Conventional Highly Selective Vagotomy and Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy on the Gastric Emptying Rate for Solid Meals in Beagle Dogs

Mistiaen, Wilhelm; Hee, R. Van; Blockx, P.

doi:10.1159/000129315

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…This view is also substantiated by clinical [2,4] and motility [6] studies. The method used in this series was equally shown to adequately decrease gastric secretion in dogs, as well as in humans, without interfering with gastroduodenal motility [5,17], As to the pancreas, 25% of the fibers of the posterior vagal trunk are directed to this organ [18], either through the celiac plexus or directly through the posterior tract of Latarjet [ 19,20].…”

Section: Discussionmentioning

confidence: 62%

“…In conclusion, the lack of postoperative diarrhea may not only be explained by a retained normal gastric motility, but also by virtually unaltered pancreatic enzyme secre tion after posterior vagal trunk section [2,4,6], PTV-AGS should, therefore, be considered a simplified and attractive alternative to high ly selective vagotomy in the treatment of chronic duodenal ulcer, avoiding some of the drawbacks of seromyotomy [5] and retaining the normal pancreatic function for up to 12 months after the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Posterior truncal vagotomy with anterior gastric wall stapling (PTV-AGS), with its ad vantages over seromyotomy [5], has already been investigated for its effect on gastric acid secretion and motility [5,6], Nevertheless, in analogy to bilateral truncal vagotomy, it may be expected that severing the posterior vagal trunk could induce an important reduction of stimulated pancreatic exocrine function [7], since the pancreatic vagal supply mainly origi nates from the posterior trunk [2,8]. We, therefore, investigated the possible changes in canine exocrine pancreatic function after PTV-AGS.…”

Section: Introductionmentioning

confidence: 99%

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Pancreatic Secretion after Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy in Dogs

Mistiaen

Hee²,

Bao³

1996

Eur Surg Res

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Anterior gastric stapling with posterior truncal vagotomy has previously been investigated for its effect on canine gastric acid reduction and motility. Posterior truncal vagotomy could, however, induce reduced pancreatic function, which has been observed after total abdominal vagotomy. In this study, pancreatic secretion has been investigated after anterior gastric stapling with posterior truncal vagotomy in a series of canine experiments by means of a stimulation test. On the long term, no significant postoperative reduction of exocrine pancreatic secretion was observed.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pancreatic Secretion after Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy in Dogs

Mistiaen

Hee²,

Bao³

1996

Eur Surg Res

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“…No doubt the canine model has been for a long time preferred in the examinations of gastric emptying. Postoperative gastric emptying disorders in dogs involving the disruption of the stomach anterior wall was reported by Mistiaen et al [ 38 ] who using a radioisotopic technique showed a significant slowdown of gastric evacuation two weeks after the operative procedure. A co-ordination between the canine gastric and duodenal activity was reported by Ehrlein and Hiesinger [ 39 ].…”

Section: Discussionmentioning

confidence: 94%

Roux-en-Y duodenojejunostomy improves gastric emptying in experimental obstruction of the distal duodenum

et al. 2018

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IntroductionWe undertook a comparative survey of gastric emptying (GE) kinetics after two variants of bypass surgery for upper bowel obstruction.Material & methodsIn 10 dogs with experimental upper bowel obstruction, five were randomized to obtain gastrojejunal anastomosis (GA), and the other five received Roux-en-Y duodenojejunal anastomosis (DA). Duplicate scintigraphic measurements of GE of a solid meal were accomplished in every animal before surgery and during the early (2–3 weeks), medium (3 months), and late (6 months) post-operative period. The GE curves were fitted with a power-exponential function to derive the GE half time T½, and the curve shape parameter S.ResultsEarly after surgery T½ slightly decreased by -18±21 min in the DA group and lengthened by 91±37 min in the GA group (p = 0.042). In both groups an increase in the S parameter was found then. In either group T½ gradually declined towards the basal value during the medium and late post-operative period. On the other hand, net differences relative to the basal situation in the S values appeared to be positive in the GA group (0.32±0.11 at 3 months; 0.64±0.19 at six months), and negative in the DA group (-0.30±0.09 at 3 months; -0.01±0.20 at six months). Hence a statistically significant contrast was found between those differences: p = 0.0022 at 3 months, and p = 0.045 at six months after the surgery.ConclusionRoux-en-Y duodenojejunal anastomosis appears to be superior to the classical gastrojejunal anastomosis while restoring patency of the gastrointestinal passage in the case of upper bowel obstruction.

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“…Furthermore, with anterior gastric stapling, perforation from too deep an incision during seromyotomy is avoided, while the completeness of intramural anterior vagotomy is guaranteed by sectioning all layers of the gastric wall. This technique has been shown to reduce gastric acid secretion adequately; radiologically and isotopically measured gastric emptying alters little [15,17]. Laparoscopic simplified alternatives to the time-consuming laparoscopic HSV such as parietal cell vagotomies (Taylor's and Hill-Barker's procedures) were already proposed to make the operation easier and faster [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up

Petrakis¹,

Vassilakis²,

Vrachassotakis³

et al. 1999

Eur Surg Res

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Background: Recently, gastric stapling with posterior truncal vagotomy has been performed by laparoscopic surgery, as an alternative to highly selective vagotomy (HSV) and the Taylor procedure for the treatment of chronic duodenal ulcer. Aim: To investigate, after a mean 5-year follow-up, the effect of the stapling-modified laparoscopic Taylor procedure, on gastric secretion, emptying and reflux as well as clinical parameters and recurrence rates in patients treated for duodenal ulcer. Methods: 16 patients, aged 38–66 years, were treated from January 1993 to January 1996 (median 60.5 months), by the laparoscopic stapling-modified Taylor procedure, using the Endo-GIA stapler device. Assessment of the results of gastric acid secretion, solid and liquid gastric emptying, enterogastric reflux, endoscopic findings and clinical parameters, using the Visick grading, was performed. Results: Endoscopy found healing ulcer in 15 patients. One patient showed signs of chronic ulcerative disease without gastritis or pyloric stenosis indicative of progressive ulcerative diathesis and was classified as Visick III. 14 patients were classified as Visick I and 1 as II. The enterogastric reflux index ranged from 0 to 26%, basal and peak acid output were 1.4 ± 0.6 and 11.7 ± 6.1 mmol H⁺/h, respectively. The half-emptying times of the solid and liquid meal were 82 ± 7 and 16 ± 6 min, respectively. These results are likely to be similar to those obtained from series of patients who underwent HSV or Taylor procedure and are closed to those from healthy controls. Conclusions: The laparoscopic modified Taylor procedure, using the Endo-GIA stapler device allows a more rapid, technically easier and radical performance of the operation with excellent long- term results and should be included in the armamentarium of the treatment of chronic duodenal ulcer.

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Comparison of the Effect of Conventional Highly Selective Vagotomy and Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy on the Gastric Emptying Rate for Solid Meals in Beagle Dogs

Cited by 6 publications

References 17 publications

Pancreatic Secretion after Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy in Dogs

Pancreatic Secretion after Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy in Dogs

Roux-en-Y duodenojejunostomy improves gastric emptying in experimental obstruction of the distal duodenum

Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up

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