Evaluation of the Vagus Preserving Gastrectomy Aiming at Prevention of Postgastrectomy Gallstone Formation.

Surgical Technique of Vagus Nerve‐preserving Gastrectomy With D2 Lymphadenectomy for Gastric Cancer

“…Several clinical studies have pointed out the increased incidence of cholelithiasis after gastrectomy with trunal vagotomy. Preservation of the extragastric branches of the vagus nerves, as achieved by selective vagotomy, ensures normal functioning of the gall bladder and reduces the incidence of gallstone development 2,7–10 . Sapala et al reported that the incidence of gallstone formation in patients undergoing gastrectomy with bilateral truncal vagotomy and without vagotomy was 21 and 6%, respectively 8 .…”

“…Rehnberg and Haglund reported that the incidence of formation of new gallstones following antrectomy and gastroduodenectomy for peptic ulcer disease was 30% after truncal vagotomy and 12% after selective vagotomy 9 . Some authors in Japan have reported that the incidence of postgastrectomy gallstone formation was 13 2 to 14.8% 10 for preservation of the hepatic branch and 3 2 to 4.9% 10 for preservation of the hepatic and coeliac branches. In our study, the incidence of gallstone formation in patients who underwent vagus nerve‐preserving distal gastrectomy and pylorus‐preserving gastrectomy was 1.8%.…”

“…The extent of innervation of the biliary tract by the hepatic and coeliac branches is unknown because the posterior vagus could not be traced through the coeliac plexus 3 . It is probably important to preserve the coeliac branch, in addition to the hepatic branch, to prevent postgastrectomy gallstone formation 2,10 …”

Long-Term Quality of Life After Laparoscopically Assisted Distal Gastrectomy for Gastric Cancer

“…9 The incidence of gallstone disease, a common postgastrectomy syndrome, has been reported to range from 18.5-36.1%. 10 Gallbladder dysfunction resulting from the resection of hepatic and celiac branches of the vagus nerve is considered to be one of the factors contributing to postgastrectomy gallstones. In our study, 12.5% of the patients suffered from cholelithiasis after LADG.…”

Survival of patients treated by an autonomic nerve-preserving gastrectomy for early gastric cancer

“…1 There are various types of function-preserving operations, including those involving a reduced extent of gastrectomy, autonomic nerve preservation, sphincter preservation, and formation of a neostomach. 2 Because the preservation of the vagus nerve has been demonstrated to improve the postoperative quality of life in patients who undergo either a vagotomy and/or gastrectomy, [3][4][5][6][7][8][9][10][11][12][13][14] we have performed an autonomic nerve-preserving gastrectomy for early gastric cancer since December 1994. Although autonomic nerve preservation has been considered to maintain the curability of patients, 15,16 the long-term survival rate after an autonomic nerve-preserving gastrectomy has not been fully assessed to date.…”