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November 1960

Gastric Vagotomy vs. Total Abdominal Vagotomy

Author Affiliations

Bellevue, Wash.
Assistant in Surgery, and Clinical Associate in Anatomy.; From the Department of Surgery (Dr. Henry N. Harkins, Professor and Executive Officer), University of Washington School of Medicine, Seattle.

Arch Surg. 1960;81(5):781-788. doi:10.1001/archsurg.1960.01300050103019

Introduction  Conventional techniques of vagotomy represent a total abdominal vagotomy that disrupts the entire parasympathetic innervation to all abdominal viscera supplied by the vagus nerves—i.e., the stomach, small intestine, proximal colon, liver, biliary tract, and pancreas. The anatomic distribution of vagal fibers, however, permits a selective gastric vagotomy that confines vagal denervation to the stomach with preservation of vagal innervation to other abdominal viscera. Results of preliminary experimental studies have indicated the anatomic and technical feasibility of this procedure (Griffith and Harkins, 1957). This report concerns initial clinical experience.

Rationale of Gastric Vagotomy: Postvagotomy Sequelae  In evaluating the variable undesirable symptoms that may follow total abdominal vagotomy, attention has focused primarily upon the flaccid achlorhydric stomach, and all efforts have been directed towards relieving gastric stasis. These efforts have been rewarding in that improved techniques of gastrojejunostomy (Oberhelman and Dragstedt, 1955), pyloroplasty (Wilkins et al., 1954), and hemigastrectomy (Farmer et

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