title: Effect of preserving the hepatic vagal nerve during laparoscopic Nissen fundoplication on postoperative biliary functions.
abstract: BACKGROUND
  Cutting the hepatic branch of the anterior vagus nerve (HB-AVn) technically facilitates the laparoscopic Nissen fundoplication. The aim of this study was to investigate the effects of preserving or sacrificing this branch on postoperative gallbladder functions.
  
  
  METHODS
  The patients (n = 40) were prospectively randomized into two groups. The HB-AVn was preserved during the dissection of the lesser omentum in the first group. The nerve was cut in the second group. Postoperative fasting gallbladder volumes were calculated by ultrasonography. Postoperative gallbladder ejection fraction (GEF) and gallbladder emptying time (GET) were determined by calculating intestinal transit time scintigraphically.
  
  
  RESULTS
  Fasting gallbladder volumes and GEF values were not different between the groups. On the other hand, in patients with HB-AVn preserved, GET measurements were found to be significantly shorter than those with HB-AVn sacrificed.
  
  
  CONCLUSIONS
  Sacrificing the hepatic branch causes prolongation in the GET. This change in the motor functions of the gallbladder does not cause any symptomatic effect during the early postoperative period. However, the delay in the GET may increase the risk of gallbladder stone formation in the long term.
authors: Department of General Surgery, Numune Training and Research Hospital, Adana, Turkey.
authors: Mehmet
authors: M
authors: Ozdogan
authors: Adnan
authors: A
authors: Kuvvetli
authors: Koray
authors: K
authors: Das
authors: Cem
authors: C
authors: Oruc
authors: Faruk
authors: F
authors: Karateke
authors: Metin
authors: M
authors: Aydin
authors: Mevlut Recep
authors: MR
authors: Pekcici
authors: Atilla
authors: A
authors: Akova
authors: Tamer
authors: T
authors: Gulsur
authors: Derya
authors: D
authors: Farsidfar
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005704:Gallbladder / Q000503:physiopathology; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000601:surgery*