New additional operation for the prevention of the gastric stasis after selective gastric vagotomy with antrectomy.
In order to prevent postoperative gastric stasis, we devised and tested the following improvements in the selective gastric vagotomy with antrectomy. (1) The gastroduodenostomy was made so as to have an acute angle to the longitudinal axis of the remnant stomach, and (2) the downward traction being exerted on the remnant stomach by the transverse colon was eliminated by dissecting the greater omentum, and then (3) the posterior wall of the corpus on the lesser curvature side was fixed to the stump of the hepatogastric ligament, and the posterior wall of the corpus on the greater curvature side was fixed to the retroperitoneum inferior to the pancreas. By these procedures, the corpus was maintained in a position superior to the anastomosis. These operative procedures resulted in preventing the gastric stasis after the start of oral feeding. The two patients on whom this operation was performed have been followed up for 3 to 4 months since the operation, and neither of them has had any complaint of gastric stasis, such as anorexia or a feeling of heaviness of the stomach.
D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying; D006801:Humans; D009852:Omentum / Q000601:surgery; D011178:Postgastrectomy Syndromes / Q000517:prevention & control*; D014629:Vagotomy, Proximal Gastric / Q000379:methods*