Roentgenographic Studies of the Gastrointestinal Tract Following Section of the Vagus Nerves for Peptic Ulcer

Pyloromyotomy: Technique and use for gastric drainage combined with vagotomy

“…Not all postvagotomy patients without drainage develop gastric stasis. In this small series of oesophagectomies without gastric decompression the incidence was 50 per cent (Table ZV), and during the era of vagotomy without drainage the reported incidence was between 10 and go per cent (Smith, Ruffin, and Baylin, 1947;Furey, 1948;Machella and Lorber, 1948;Ritvo and Shauffer, 1948). A wide pyloric ring found at operation does not necessarily mean that drainage is not required; 'spasm' may still occur and this may not be restricted to the pyloric ring.…”

“…LATERJET (1922) stated that gastro-enterostomy prevented stasis from occurring in the denervated stomach and McCrea (1926) also recognized that vagus section caused pylorospasm and gastric atony. Dragstedt and Owens (1943) at first advocated vagotomy without gastric drainage for the treatment of duodenal ulcer and this resulted in a high incidence of gastric stasis and recollection of the need for gastroenterostomy (Smith, Ruffin, and Baylin, 1947;Furey, 1948;Machella and Lorber, 1948;Ritvo and Shauffer, 1948). Later, pyloroplasty became fashionable (Wilkens, Weinberg, and Farris, 1951 ;Weinberg, Stempian, Movius, and Dagradi, 1956;Stempien, Dagradi, and Seifer, 1958).…”

“…The mean reduction of gastric residue after stretch myotomy was 33 per cent. Ritvo and Shauffer (1948) noted that gastric emptying times after vagotomy without drainage were very variable and that gastric dilatation occurred even with gastro-enterostomy, although the emptying of the pylorus. Not all postvagotomy patients without drainage develop gastric stasis.…”