Present position of the electrical stimulation test.

Burge, Harold; Roberts, T B; Stedeford, R. D.; Lancaster, Michael

doi:10.1136/gut.10.2.155

Cited by 8 publications

(3 citation statements)

References 2 publications

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“…Burge's electrical stimulation test (Burge and Vane, 1958;Burge, Roberts, Stedeford, and Lancaster, 1969) has not met with general acceptance because it is inconvenient and of questionable reliability (Lythgoe, 1961;Clark and Murray, 1963). Lee's new method appeared to offer an attractive alternative.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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show abstract

“…Moreover, having selected an operation incorporating vagotomy, the surgeon's confidence in achieving total gastric vagotomy cannot always be complete. Burge et al (1969) uses an electrical stimulation test that has not become generally popular; Lee (1969) has described a dye method to stain residual nerve fibres.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Surgery ‐ Part III: Recurrent Ulcer following Surgery for Peptic Ulcer

Kirk

1970

Int J Clinical Practice

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“…The drainage procedure was pyloroplasty in 23 patients and gastroenterostomy in the other seven. Twenty-eight patients had been tested for completeness of vagotomy either at the time of surgery by the electrical stimulator test (Burge, Roberts, Stedeford, and Lancaster, 1969) or postoperatively by the acid secretory response to insulin hypoglycaemia (Hollander, 1946). Only one patient of those tested had evidence of incomplete gastric vagotomy.…”

Section: Methodsmentioning

confidence: 99%

Serum gastrin in duodenal ulcer: Part IV Effect of selective gastric vagotomy

Korman¹,

Hansky²,

Coupland³

et al. 1972

Gut

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SUMMARY Serum gastrin has been measured in 30 patients following selective gastric vagotomy. Basal serum gastrin was 52+5.7 pg/ml which was significantly lower than the corresponding level in 50 patients following truncal vagotomy (84+7.9 pg/ml). After a standard protein meal serum gastrin rose to 136±8.3 pg/ml at 60 minutes after the meal. The peak rise above basal levels was significantly lower than that achieved in patients who had undergone truncal vagotomy.These results complement our previous hypothesis that section of extragastric vagal fibres permits the release of additional gastrin above that expected with the diminution of acid secretion, and hence the decrease in inhibition of gastrin release from the antrum. Korman, Hansky, and Scott (1972) suggested that truncal vagotomy permits the release of gastrin from the antrum and other sites. They postulated that the mechanism for this release is a combination of diminution in gastric acid secretion and removal of an inhibitor to extragastric gastrin release by section of extragastric vagal fibres.The Roberts, Stedeford, and Lancaster, 1969) or postoperatively by the acid secretory response to insulin hypoglycaemia (Hollander, 1946). Only one patient of those tested had evidence of incomplete gastric vagotomy.Four patients with a complete gastric vagotomy were then further investigated. Each fasting patient was given a standard protein meal (Korman, Soveny, and Hansky, 1971) and peripheral venous blood collected at -30, 0, 15, 30, 45, 60, 75, 90, 105, and 120 minutes after protein. The protocol was identical to that reported for truncal vagotomy (Korman et al, 1972). The serum gastrin responses could thus be compared. Serum gastrin was estimated by radioimmunoassay (Hansky and Cain, 1969;Hansky, Soveny, and Korman, 1971b

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Present position of the electrical stimulation test.

Cited by 8 publications

References 2 publications

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

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

Abdominal Surgery ‐ Part III: Recurrent Ulcer following Surgery for Peptic Ulcer

Serum gastrin in duodenal ulcer: Part IV Effect of selective gastric vagotomy

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