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October 1966

Gastrointestinal Function Following Vagotomy and Pyloroplasty

Arch Surg. 1966;93(4):578-582. doi:10.1001/archsurg.1966.01330040042006

TODAY gastric surgery is based on Physiology," epigrammatically states Harold Burge at the beginning of his book, Vagotomy.1 Indeed, vagotomy combined with drainage procedure is now performed successfully on a larger scale than before on patients who ten years ago would have invariably been treated by gastrectomy, and this fact marks the most outstanding feature of this modern trend in gastric surgery.

The postoperative management of the patient, however, often follows the same lines as that following gastrectomy, although vagotomy with drainage is not as major a procedure as gastrectomy.

The longstanding gastric retention following vagotomy, treated by prolonged gastric aspiration, has been accepted and explained as a result of gastrointestinal inactivity after any major abdominal operation and has been attributed to loss of motility of the stomach.2-7 But the presence of bowel sounds as a manifestation of resumed peristalsis sometimes coexists with increased gastric aspiration. The problem,

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