Technical Complications of Transabdominal Vagotomy

THERE IS satisfactory evidence that bilateral total subdiaphragmatic vagotomy is an effective operative procedure in combination with antrectomy or gastric drainage procedures for the treatment of the surgical complications of peptic ulcer. Not only is the incidence of recurrent ulceration less than with resection alone, but vagotomy allows preservation of an adequate gastric reservoir, the loss of which is associated with so many long-term side effects.^1-4 Total subdiaphragmatic vagotomy is generally a simple procedure but its safe performance depends on the recognition of potential serious technical errors. We have reviewed 883 subdiaphragmatic vagotomies in an attempt to determine the frequency and type of complications encountered during operation.

Methods  The hospital records of all patients who underwent vagotomy or attempted vagotomy at the Presbyterian Hospital and the Francis Delafield Hospital during the 14-year-period, 1951 to 1964, were reviewed. The operative note, pathology report, and postoperative course were reviewed in detail.