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August 1958

Hyperfunction of Gastric Antrum Following Vagotomy and Pyloroplasty

Author Affiliations

Los Angeles
From the Wadsworth General Hospital, Veterans' Administration Center, and the Department of Surgery, University of California Medical Center.

AMA Arch Surg. 1958;77(2):289-293. doi:10.1001/archsurg.1958.01290020139025

The hypersecretion of acid gastric juice, characteristic of the patient with duodenal ulcer, is abolished by complete division of the vagus nerves to the stomach. The interruption of the nervous phase of gastric secretion is generally considered to be the basic principle accounting for the favorable therapeutic results obtained by this method. Unfortunately, vagotomy also exerts a potent influence on gastric motor activity, and the need for an ancillary drainage procedure is apparent. Gastroenterostomy has been widely used for this purpose and has been successful in promoting adequate emptying of the vagotomized stomach. Prominent among disadvantages of this procedure is the interference with normal, acid-base control of the antral "gastrin" mechanism. Reflux of alkaline Duodenal fluids promotes the excessive release of the gastric hormone; this is influenced to a large extent by the location and size of the gastrojejunal stoma.1-4 A high-lying gastrojejunostomy promotes retention in the dilated vagotomized

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