Kommentar Gastric Vagotomy in Duodenal Ulcer

Abstract

The employment of gastric vagotomy in the definitive surgical treatment of duodenal ulcer is based upon the concept that this lesion is usually caused by a hypersecretion of gastric juice of nervous origin. The evidence in support of this view may be summarized as follows:

• 1. If adequate methods of measurement are used, duodenal ulcer patients will usually be found to secrete from three to twenty times as much acid in the fasting stomach at night as do normal people.

• 2. If a hypersecretion of this degree is reproduced in experimental animals, they regularly develop duodenal ulcers.

• 3. If the vagus nerves to the stomach in duodenal ulcer patients are completely divided, the hypersecretion of gastric juice in the empty stomach is abolished, indicating that it is of nervous origin.

• 4. If the gastric vagotomy in duodenal ulcer patients is combined with removal of the antrum of the stomach or with an adequate drainage procedure which prevents stasis of food in the antrum, the duodenal ulcers heal and remain healed.

This work has been aided by Grant No. AM-04178 from the Division of Research Grants and Fellowships of the National Institutes of Health, United States Public Health Service.