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July 1968

Changes in the Pylorus Following Vagotomy in Dogs

Author Affiliations

From the Department of Surgery, Temple University Health Sciences Center, Philadelphia.

Arch Surg. 1968;97(1):108-110. doi:10.1001/archsurg.1968.01340010138016

RESECTION of the vagus nerves has played an increasingly important role in the surgery of gastroduodenal ulcer disease. Vagotomy was used in the treatment of duodenal ulcer as early as 1908 in some European clinics. In 1938, Winkelstein and Berg reported on the use of vagotomy in the treatment of duodenal ulcer in this country.1 It remained, however, for Dragstedt to popularize its use in the United States.2

The observation that a "drainage" procedure was necessary to allow gastric emptying after vagotomy was made in 1949 and generally accepted in the 50's.3,4 The mechanism of the delay in gastric emptying which follows vagotomy is incompletely understood. The delay has been attributed to a reduction in the tone and motility of the stomach and to some degree of pylorospasm. Evidence to support pylorospasm has been meager, and indeed, at least one author has presented evidence that pylorospasm is

Winkelstein, A., and Berg, A.A.:  Vagotomy Plus Partial Gastrectomy for Duodenal Ulcer , Amer J Dig Dis 5:497-501 ( (Oct) ) 1938.Article
Dragstedt, L.R., and Owens, F.M.:  Supradiaphragmatic Section of the Vagus Nerves in the Treatment of Duodenal Ulcer , Proc Soc Exp Biol Med 53:152-154 ( (June) ) 1943.Article
Healy, M.J., Jr., and Saver, P.K.:  Some Limitations of Vagotomy in the Treatment of Peptic Ulcer , Ann Surg 130:985-1007 ( (Dec) ) 1949.Article
Oberholman, H.A., Jr., and Dragstedt, L.R.:  New Physiologic Concepts Related to the Surgical Treatment of Duodenal Ulcer by Vagotomy and Gastroenterostomy , Surg Gynec Obstet 101:194-200 ( (Aug) ) 1955.
Quigley, J.P., and Louckes, J:  The Effects of Complete, Vagotomy on the Pyloric Sphincter and the Gastric Evacuation Mechanism , Gastroenterology 19:533-537 ( (Nov) ) 1951.
Louckes, H.: Quigley, J.P.: and Kinsey J.:  Inductograph Method for Recording Muscle Activity, Especially Pyloric Sphincter Physiology , Amer J Physiol 199:301-310 ( (Aug) ) 1960.
Machella, T.E., and Lorber, S.H.:  Gastrointestinal Motility Following Vagotomy and the Use of Orecholine for the Control of Certain Undesirable Phenomena , Gastroenterology 11:426-441 ( (Oct) ) 1948.
Aust, J.B.:  A New Technique for Pyloroplasty , Surgery 53:309 ( (March) ) 1963.
Zimmerman, L.M., and Levine, R.: Physiologic Principle of Surgery , Philadelphia: W. B. Saunders Co., 1964.