Indications for Gastrostomy After Vagotomy

SOME FORM of postoperative gastric decompression is usually considered necessary following complete division of the vagus nerves and the construction of a pyloroplasty in the treatment of duodenal ulcer. In spite of the drainage procedure gastric stasis may prove a problem in the early postoperative period.¹ Two types of decompression are used. Nasogastric intubation, which is most frequently used in this country, has caused several serious complications^2,3 as well as being an unpleasant feature of the patient's postoperative convalescence. Temporary gastrostomy has been advocated to prevent these complications.³ However, this technique has its own complications⁴ which can be markedly reduced by careful attention to the method of construction of the gastrostomy.^5,6 The fluid lost in the gastric aspirate is usually replaced by intravenous infusion which is another minor irritation.

One way of avoiding both intravenous fluid therapy and nasogastric intubation is the use of a