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Postvagotomy Gastric Atony

RICHARD O. KRAFT, MD; WILLIAM J. FRY, MD; MARION S. DeWEESE, MD
Arch Surg. 1964;88(5):865-874. doi:10.1001/archsurg.1964.01310230141027.
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Introduction  Vagotomy and gastric drainage is an increasingly popular procedure in the care of patients with complicated duodenal ulcer disease. The infrequency of major morbidity is in part responsible for the enthusiasm with which this operation has been received. This study is concerned, however, with one significant complication which is peculiarly related to this operation—postvagotomy gastric atony.

Definitions  Gastric atony is a motor dysfunction of the stomach resulting in profound gastric retention in the absence of organic obstruction. This failure of the stomach to empty must by definition not be secondary to any of the other well-recognized complications such as intraperitoneal abscess, wound infection, pancreatitis, hypokalemia, hyponatremia, hypoproteinemia, thrombo-embolism, pneumonitis, and cardiovascular alterations. The dysfunction must, in addition, be responsible for a prolonged postoperative course, with more than 14 days elapsing between primary surgical intervention and discharge of the patient from the hospital. A protracted postoperative course due to

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