Supra-highly selective vagotomy for peptic ulcer is widely used at pioneer hospital because of advantages of low morbidity, low mortality, less extensive operation, but has a recurrence rate that is comparable with or even higher than other
surgical
procedures for peptic ulcer.
Supra-highly selective vagotomy maintains gastric motor function of antral-pyloric coordination necessary for emptying, storage of food with exclusion of acid secretory function of parietal cell at fundus and body of stomach.
Because of its low early and late morbidity, mortality, less or the least probability of such complications as small capacity syndrome, dumping syndrome, afferent and efferent loop syndrome, reflux gastritis, early recovery to better, safe life,
supra-highly selective vagotomy has emerged as the preferred operation for duodenal ulcer.
Classical indication of this operation was chronicity, but extended to complicated ulcer, that is, perforation, partial obstruction, bleeding recently.
Highly selective vagotomy is procedure that denervated fundus and body branch of Latarjet nerve innervating along lesser curvature of stomach, but supra-highly selective vagotomy is procedure that denervate first branch of crow's foot and right
gastroepiploic nerve fiber descending along gastroduodenal artery and right gastroepiploic artery, a branch of celiac branch, innervating to antrum and body portion of stomach at greater curvature side.
So, later procedure provides more accurate reduction of acid secretion.
The authors obtamed good clinical results by short-term follow-up with the application of suprahightly selective vagotomy for complicated duodenal ulcer in 9 cases at the Department of Surgery, College of Medicine, Chosun University Hospital in
the
period from July 1989 to June 1990.
@ES The clinical results were as follows ;
@EN 1) All of 9 cases were men, 5 of 9 cases were 4th decase.
2) 5 of 9 cases were emergency operation, 4 were elective case.
3) The mean time interval from onset of perforation to operation was about 12 hours.
4) The mean operation time was about 2 hi 25 min.(The shortest; 2 hr 0.5min, the longest; 3 hr 10 min)
5) The mean duration of admission was about 11 days(The shortest; 6 days, the longest; 19 days).
6) According to Visick classification, Grade I was 6 cases, II 2 cases, III 1 cases.
7) Endoscopic follow-up 3 months after operation twice in 3 cases revealed progressive resolution of ulcer.
8) Complications in 2 cases during admission after operation were operation site breeding in one cirrhotic patient and wound dehiscence in the other patients.
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