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An Unsatisfactory Drainage Procedure for Vagotomy

Ward O. Griffen, Jr., MD, PhD; J. David Richardson, MD; Reginald Bolick, MD

AMA Arch Surg. 1971;103(2):140-146.

Abstract
In a group of ten patients undergoing vagotomy and gastroenterostomy for duodenal ulcer, five proved and two suspected recurrent (marginal) ulcers were seen after eight years' follow-up. Since this was a much higher recurrence rate than that after pyloroplasty, a review of the literature on the reported efficacy of the two drainage techniques was undertaken. Following 1,657 pyloroplasties, the recurrence rate was 3.8%, whereas a 9.6% incidence was reported after 2,508 gastroenterostomies. The late complications and patient dissatisfaction were higher in the gastroenterostomy group. The afferent loop syndrome may be seen only in patients with a gastric-jejunal anastomosis. The single advantage for gastroenterostomy, namely that it avoids dissection in the area of maximum scarring, may be obviated by a side-to-side gastroduodenostomy which possesses all of the physiologic advantages of a pyloroplasty. It is concluded that gastrojejunostomy is the least satisfactory drainage procedure for a vagotomy.

Author Affiliations
Lexington, Ky

From the Department of Surgery, University of Kentucky Medical Center, Lexington.

Footnotes
Accepted for publication March 13, 1971.

Read before the 28th annual meeting of the Central Surgical Association, Minneapolis, March 4, 1971.

Reprint requests to Department of Surgery, University of Kentucky Medical Center, Lexington, Ky 40506 (Dr. Griffen).

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