DURING major surgical procedures, precautions are taken to avoid trauma to important structures. In surgical procedures on the uterus, the ureters are cautiously avoided; in surgery of the gallbladder, one is careful not to damage the hepatic artery or the common bile duct. What are the operative dangers during vagotomy? In an attempt to answer this question, we have reviewed 325 consecutive vagotomies (258 transabdominal and 67 transthoracic) performed at Birmingham Veterans Administration Hospital between June 10. 1946 and March 10, 1949.
Weeks and Ryan reported a death on the operating table during supradiaphragmatic vagotomy which they thought resulted from an abnormal vagal reflex, although permission for autopsy was not obtained, and, to quote them, "assessment as to the cause of death must be in part speculative."1 Moore, Chapman, Schulz and Jones reported a cardiac arrest which occurred while a transthoracic vagotomy was being performed, resulting in death postoperatively.