No abstract available.
Duodenal Ulcer* ; Vagotomy, Truncal*

No abstract available.
Duodenal Ulcer* ; Vagotomy*

Patients under 65 with perforated duodenal ulceration received vagotomy as method of Taylor or Hill barker in ViÖt §øc during 1992-1998. The results of nervous anatomy and clinical practice has shown that vagal structure in the below of diaphragm was various: 45% of anterior vagus had 2-3 stems, 29% of posterior vagus had 2 stems, 30% of vagus had vago accessorius which lies along with left of esophago abdominal wall, there were changes of number of stem latarjet. The operation as Hill Barker can reduced peptic acid better than this as Taylor
Vagus Nerve ; anatomy & histology ; Vagotomy

Gastroparesis is a clinical term for gastric dysmotility or paralysis that presents without mechanical obstruction, but with functional obstruction. Nausea, vomiting, abdominal discomfort and abdominal distension may result from the functional obstruction of gastroparesis. Gastroparesis is frequently associated with such systemic diseases as diabetic mellitus and scleroderma or with certain operations such as vagotomy. Yet gastroparesis is rarely described in older children after viral infection. The authors observed a case of gastroparesis after pyretic symptoms. We report here on this case and its clinical consequences.
Child ; Gastroparesis ; Humans ; Nausea ; Paralysis ; Vagotomy ; Vomiting

Gastric peptic ulcer operation is designed to reduce gastric secretion, of gastric acid and pepsin enough to control the peptic ulcer diathesis and also to have least complications after operation which are related to alterations of gastric motility and emptying rate. The author studied the physiologic effects of proximal gastric vagotomy with pyloroplasty on the gastric secretion, gastric acid, gastric pepsin, gastric motility and gastric emptying rate by means of the ballon-physiographic method through gastric fistula. In this exprimental studies, 2 kinds of animal i.e. dogs and cats were used. 15 dogs were used which were divided into 5 groups i.e. gastrostomy for control, proximal gastric vagotomy, truncal vagotomy only and truncal vagotomy with gastric pyloroplasty. Cats were used 25 ones which were divided into 3 groups i.e. gastrostomy for control, proximal gastric vagotomy and truncal vagotomy and following results and conclusion were obtained. 1. Important role on the gastric secretion, gastric acid, gastric pepsin, gastric motility, gastric emptying and the relationship between the intragastric pressure and volume.2. Both proximal gastric vagotomy and subtotal gastrectomy(Billroth II) made a marked reduction on the gastric secretion, gastric acid and gastric pepsin than that of control group but were similar to control group on the gastric motility and gastric emptying rate. 3. Truncal vagotomy alone caused marked reduction on gastric secretion, gastric acid and gastric pepsin and showed remarkable slowness on gastric motility and gastric emptying rate. 4. The wave of contraction and motility index in duodenum were more higher than that gastric body and antrum and antral contraction is higher than that of gastric body in control groups. 5. Pacesetter potential is formed by intrinsic myogenic phenomena and is related to motor activity and gastric emptying. 6. Truncal vagotomy with pyloroplasty hastened the gastric emptying rate of liquid meals and rate of emptying of solid meals was slightly faster than that of control groups. 7. Emptying of liquid meal is controlled by intragastric transmural pressure and emptying of solid meal is controlled by antral contraction. 8. The vagus distributed on the stomach was divided into cholinergic excitory fibers and noncholinergic or nonadrenergic inhibitory fibers. As gastric vagal inhibitory fibers were cut when vagotomy was done, pyloroplasty was must be done.
Animals ; Cats ; Disease Susceptibility ; Dogs ; Duodenum ; Gastric Acid ; Gastric Emptying ; Gastric Fistula ; Gastrostomy ; Meals ; Motor Activity ; Pepsin A ; Peptic Ulcer* ; Stomach ; Vagotomy ; Vagotomy, Proximal Gastric ; Vagotomy, Truncal

The effects of intraventricular atropine on the heart rate was investigated in the rabbit. Intraventricular administration of atropine in a dose of 10, 30, 100, or 300 ug produced dose dependant bradycardia. Atropine (100 ug) induced bradycardia was abolished by bilateral vagotomy or intravenous atropine, and inhibited by intravenous propranolol but not by intravenous Regitine. Intraventricular Ecolid or regitine pretreatment diminished the bradycardia induced by intraventricular atropine. From the above results, it is suggested that a central adrenergic mechanism as well as vagal activity plays an important role in the intraventricular atropine-induced bradycardia.
Atropine* ; Bradycardia ; Chlorisondamine ; Heart Rate* ; Heart* ; Phentolamine ; Propranolol ; Vagotomy

BACKGROUND: To evaluate the effects of thoracic epidural anesthesia, with or without bilateral vagotomy, epinephrine-induced arrhythmias were studied in 31 rabbits anesthetized with 1 MAC enflurane. METHODS: Logdose protocol was used for the infusion of epinephrine; its arrhythmic dose being defined as the smallest infusion rate produced four or more continuous or intermittent arrhythmias within 15 seconds. RESULTS: The values (geometric mean) of arrhythmic doses and the plasma concentration of epinephrine during arrhythmia were as follows: 10.21 g.kg 1.min 1 and 83.16 ng/ml in epidural control group; 118.90 g.kg 1.min 1 and 677.76 ng/ml in epidural lidocaine group (p<0.05); 6.34 g.kg-1.min 1 and 96.42 ng/ml in intravenous lidocaine group; 8.65 g.kg 1.min-1 and 44.64 ng/ml in vagotomized-epidural control group; and 12.03 g.kg 1.min 1 and 95.35 ng/ml in vagotomized- epidural lidocaine group. CONCLUSIONS: The data suggest that thoracic epidural anesthesia raises the threshold for enflurane- epinephrine arrhythmias in rabbits and that this effect is eliminated by bilateral vagotomy.
Anesthesia, Epidural* ; Arrhythmias, Cardiac* ; Enflurane ; Epinephrine ; Lidocaine ; Plasma ; Rabbits* ; Vagotomy*

BACKGROUND: The aim of this study is to show the effectiveness and the safety of laparoscopic surgery for the treatment of complicated duodenal ulcers. METHODS: From September 1994 to July 1997, 30 hemodynamically stable patients underwent laparoscopic surgery for the treatment of complicated duodenal ulcers, including 13 free perforations, 12 obstructions and 5 intractabilities. Operations consisted of a truncal vagotomy with a drainage procedure, a proximal gastric vagotomy (posterior truncal vagotomy with anterior seromyotomy) and simple closure of the perforation in 16, 9, 5 cases, respectively. In the beginning of this study, congo-red tests were attempted in 12 patients, intraoperatively in 7 and postoperatively in 5, to assess the reliability of a laparoscopic vagotomy. Long-term follow up was evaluated using by modified Visik criteria. RESULTS: The mean operation time was 150 (80-230) minutes. Oral intake resumed on the third postoperative day. The mean hospital stay was 8.4 days. There was one intraoperative open conversion. In another case, a distal subtotal gastrectomy followed due to persistent postoperative gastric stasis. Six of 7 intraoperative congo red tests showed black-to-red discoloration of the gastric mucosa, which meant reduced gastric acidity. However, in the postoperative group, only 2 of 5 cases did. The mean follow-up period was 21 (3-38) months. There were 2 recurrent ulcers. One was on the duodenum; the other was a marginal ulcer. CONCLUSIONS: Laparoscopic surgery for the treatment of complicated duodenal ulcers is technically feasible, effective, and safe.
Congo Red* ; Congo* ; Drainage ; Duodenal Ulcer* ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Acid ; Gastric Mucosa ; Gastroparesis ; Humans ; Laparoscopy ; Length of Stay ; Peptic Ulcer ; Ulcer ; Vagotomy* ; Vagotomy, Proximal Gastric ; Vagotomy, Truncal

BACKGROUND : Truncal vagotomy produces a reduction in bile flow, an increased gallbladder volume, a delay in gallbladdr emptying, decrease in resting pressure, and decreased contraction following stimulation with cholecystokinin. Retrospective studies have suggested that vagotomy can be responsible for a 4 to 6 fold increase in the 4% to 5% control rate of cholelithiasis noted in the Framingham study. The measurement of the gallbladder ejection fraction by using Tc-99m DISIDA scintigraphy is suitable for the study of the motor functions of the gallbaldder. A gallbladder ejection fraction of less than 35% is highly predictive of the presence of gallbladder disease and is a good indicator of a favorable outcome following a cholecystectomy. METHODS : Between January 1995 and December 1996, 24 patients (truncal vagotomy + pyloroplasty, 5; truncal vagotomy partial + gastrectomy + Billroth I, 4; truncal vagotomy + partial gastrectomy + Billroth II, 12; total gastrectomy, 3) and 18 healthy volunteers were investigated prospectively by Tc-99m DISIDA scintigraphy for the measurement of the gallbladder ejection fraction. RESULTS : In normal subjects, the mean value of the gallbladder ejection fraction was 70.8%, and in patients after a gastric operations, it was 66.0% (p>0.05). Three (25.0%) of the 12 patients with a truncal vagotomy, partial gastrectomy, and Billroth II gastrojejunostomy had gallbladder ejection fractions of less than 35% (p<0.05). CONCLUSIONS : There was no difference in the gallbladder ejection fractions between the control group and the patients after gastric operations, including a truncal vagotomy. However there was a significant difference between the patients with a truncal vagotomy, partial gastrectomy, and Billroth II anastomosis and those receiving other gastric operations.
Bile ; Cholecystectomy ; Cholecystokinin ; Cholelithiasis ; Gallbladder Diseases ; Gallbladder* ; Gallstones ; Gastrectomy ; Gastric Bypass ; Gastroenterostomy ; Healthy Volunteers ; Humans ; Prospective Studies ; Radionuclide Imaging* ; Vagotomy ; Vagotomy, Truncal

Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It is severe complications of gastrojejunostomy, which results an inadequate resection or incomplete vagotomy during peptic ulcer surgery. The symptoms are diarrhea, upper abdominal pain, bleeding, vomiting and weight loss. A 55-year-old man with chronic diarrhea and weight loss for 6 months visited Dankook University Hospital. The patient had received a truncal vagotomy and gastrojejunostomy for duodenal ulcer obstruction 15 years previously. The patient underwent gastroscopy and upper gastrointestinal series evaluations, which detected the gastrojejunocolic fistula. After improving of malnutrition, an exploratory laparotomy was undertaken, which revealed that the gastrojejunostomy site and the T-colon formed adhesion and fistula. En block resection of the distal stomach and T-colon included the gastrojejunocolic fistula, and Roux-en-Y gastrojejunostomy was performed. Recovery was uneventful and the patient remained well at the follow-up. We report a gastrojejunocolic fistula, which is a rare case after gastrojejunostomy.
Abdominal Pain ; Diarrhea ; Duodenal Ulcer ; Fistula ; Follow-Up Studies ; Gastric Bypass ; Gastroscopy ; Hemorrhage ; Humans ; Laparotomy ; Malnutrition ; Peptic Ulcer ; Stomach ; Vagotomy ; Vagotomy, Truncal ; Vomiting ; Weight Loss