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
Maier WP, Masloff ML, Rosemond GP. Changes in the Pylorus Following Vagotomy in Dogs. Arch Surg. 1968;97(1):108–110. doi:10.1001/archsurg.1968.01340010138016
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