Late Results of Vagotomy Combined with Gastro-jejunostomy or Pyloroplasty in the Treatment of Duodenal Ulceration

Davies, Julia

doi:10.1136/bmj.2.5001.1086

Cited by 26 publications

(5 citation statements)

References 10 publications

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“…Food dumping too fast is recorded (Moore, 1963). Some find no delay in gastric emptying (British Medical Journal, 1958), others report 6 % (Davies, 1956) or 28 % (Bergin and Jordan, 1959) cases of gastric stasis. Our series suggests that this operation, which heals the widest variety of ulcers, causes marked delay in gastric emptying.…”

Section: Normal Patientsmentioning

confidence: 99%

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Buckler¹

1967

Gut

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Section: Normal Patientsmentioning

confidence: 99%

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Buckler¹

1967

Gut

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“…Due to the high incidence of incomplete vagotomy (Davies, 1956;Ross and Kay, 1964;Johnston, Thomas, Checketts, and Duthie, 1967) there is a need for a simple and reliable intraoperative method for achieving complete vagal section. Lee (1969) recently described a selective nerve stain, leucomethylene blue', which he claimed reliably stained small vagal fibres.…”

mentioning

confidence: 99%

The selective nerve stain leucomethylene blue as an intraoperative aid to achieving complete vagotomy

Frimer¹,

Cohen²,

Harrison³

et al. 1970

Gut

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SUMMARYThe recently reported vagal nerve stain leucomethylene blue was assessed in 20 patients as an intraoperative aid to attaining complete vagotomy. Of 101 stained specimens removed at surgery, only 30 (30%) contained nerve tissue. Four of 17 postoperative insulin tests were positive by Hollander's criteria. The dye technique was found to be an unreliable method of ensuring complete vagotomy at the time of surgery.Due to the high incidence of incomplete vagotomy (Davies, 1956;Ross and Kay, 1964;Johnston, Thomas, Checketts, and Duthie, 1967) there is a need for a simple and reliable intraoperative method for achieving complete vagal section. Lee (1969) recently described a selective nerve stain, leucomethylene blue', which he claimed reliably stained small vagal fibres. The present report describes our experience with the dye in 20 patients. Material and MethodsFor this study 20 patients undergoing vagotomy for peptic ulcer disease were selected at random over a three-month period. The operations were performed by 14 different surgeons but the stain was applied and the specimens removed in each instance by one of the authors (M.L.F.).The technique employed was similar to that described by Lee with the exception that the left gastric artery was not divided. After dissection of the peritoneum and division of both main vagal trunks, leucomethylene blue was applied to the bared anterior and posterior surfaces of the oesophagus using a cotton swab. Considerable

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“…Using these criteria there have been wide variations in the incidence of incomplete vagotomy reported from different surgical series, 14% by Woodward, Harper, Tovee, and Dragdstedt (1949), 43% by Weinstein, Hollander, Lauber, and Colp (1950), 30% by Davies (1956), 12% by Lythgoe (1961), and 27% by Ross (1964).…”

mentioning

confidence: 99%

Response to insulin of the intact stomach in patients with duodenal ulcer

Gillespie¹,

Gillespie²,

Kay³

1969

Gut

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SUMMARY Insulin tests were performed on 47 duodenal ulcer patients with intact stomachs. Only 20 had a positive response to the test judged positive by the criteria of Hollander in the first 45 minutes after the insulin. Twenty became positive between 45 and 60 minutes, and in five the response was not noted until the second hour. Surprisingly, two patients had apparently negative responses to the insulin. While caution is necessary in comparing responses of the intact stomach to those after vagotomy operations, the occurrence of the 'late positive' and negative patterns of response to insulin in the intact stomach may give rise to reservations about the interpretation of these types of response after vagotomy.

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Late Results of Vagotomy Combined with Gastro-jejunostomy or Pyloroplasty in the Treatment of Duodenal Ulceration

Cited by 26 publications

References 10 publications

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

The selective nerve stain leucomethylene blue as an intraoperative aid to achieving complete vagotomy

Response to insulin of the intact stomach in patients with duodenal ulcer

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