PMID: 1203664Dec 6, 1975Paper

Operative mortality and postoperative morbidity of highly selective vagotomy

British Medical Journal
D Johnston

Abstract

In a world-wide survey of the results of 5539 highly selective vagotomies (HSVs) performed electively for duodenal ulcer the operative mortality was found to be 0-3%. This was lower than that found in collected series after either vagotomy with drainage (0-8%) or gastric resection with or without vagotomy (over 1%). Necrosis of the lesser curvature occurred in 10 patients (0-2%) after HSV and caused death in 5(0-1%). Such necrosis is probably ischaemic in origin. Hence reperitonealisation of the raw area on the lesser curvature and prompt laparotomy if the patient develops signs of peritonitis might lower the mortality still further. Three deaths were due to pulmonary embolism, one to mesenteric vascular occlusion, and four to myocardial infarction; such deaths might be reduced by the prophylactic use of low-dose heparin. Persisting gastric stasis requiring drainage occurred in only 0-1% of the patients in the early postoperative period and in 0-6% of the patients later. Hence drainage procedures, which produce side effects such as early dumping, bilious vomiting, and diiarrhoea, could be abandoned if the mean incidence of recurrent ulceration after HSV remains close to its present level. HSV is probably the safest operation fo...Continue Reading

References

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Citations

Nov 1, 1985·Digestive Diseases and Sciences·J P Bader
Aug 31, 1979·World Journal of Surgery·M M LinderR Rethel
May 1, 1977·World Journal of Surgery·G Uhlschmid, F Largiadèr
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Jun 2, 1979·British Medical Journal·T KennedyT G Parks
Apr 20, 1985·British Medical Journal·A Sonnenberg
Sep 7, 1985·British Medical Journal·T V Taylor
Dec 17, 1988·BMJ : British Medical Journal·G J CooperA G Johnson
Mar 1, 1976·Postgraduate Medical Journal·H Ellis
Dec 20, 1977·Gastrointestinal Radiology·B S Jay, M Burrell
May 1, 1975·Biopolymers·B B DoyleE R Blout
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Mar 1, 1994·American Journal of Surgery·S J Waisbren, I M Modlin
Mar 1, 1980·American Journal of Surgery·L J DiDioP C Chandnani

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