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The Effect of Highly Selective Vagotomy Plus Mucosal Antrectomy and Highly Selective Vagotomy Alone on Motor Function of Gastric Antrum

Objective To investigate the effects of highly selective vagotomy plus mucosal antrectomy (HSVMA) and highly selective vagotomy (HSV) alone on the functions of the gastric antrum. MethodsEighteen dogs and 48 patients with chronic duodenal ulcer were tested. The time of gastric emptying, antral myoelectric activity, antral pressure were measured 4-6 months after operation in 18 dogs which were randomized into the control, HSV and HSVMA groups. The gastric evacuation, frequency and amplitude of electrogastrography (EGG) were observed 4-6 months after operation in 48 patients who were randomly divided into HSV (20 patients) and HSVMA (28 patients) group, their preoperative values were considered as control group. ResultsIt was found by barium meal examinations that the shape of the stomach and duodenum was normal and gastric peristalsis was clearly visible in all the animals and patients of two postoperative groups. The beginning and ending time of gastric emptying were (5.0±0.06) min and (4.0±0.4) h respectively in the dogs of HSVMA group, which were similar to those of the dogs of control and HSV group (Pgt;0.05). The frequency of the antral myoelectric action potential was (3.11±0.65 ) cycles/min in the dogs of HSVMA group, the frequency of EGG was (3.25±0.75) cycles/min in the patients of HSVMA group, which were significantly lower than that of the dogs or patients of control and HSV group (P＜0.05). Injection of pentagastrin in dogs or taking meal in patients significantly increased the antral pressure or amplitude of EGG. Conclusion The motor function of the reconstructed antrum in the HSVMA group approaches the normal level despite a lower antral myoelectric frequency. It is believed that HSVMA will be a choice for the treatment of duodenal ulcer.