PHYSIOLOGICAL OUTCOME FOLLOWING LAPAROSCOPIC HIGHLY SELECTIVE VAGOTOMY - A CONTROLLED-STUDY IN A PIG MODEL

Open highly selective vagotomy (HSV) has withstood the rigors of objec tive evaluation to become the optimal surgical treatment for chronic d uodenal ulcer refractory to medical therapy in many centers, Laparosco pic HSV has not been subjected to the same scrutiny before entering cl inical practice. A controlled animal study was conducted to demonstrat e the physiological validity of laparoscopic HSV. Experimental groups underwent laparoscopic and open highly selective vagotomies, and contr ol groups underwent a sham laparoscopic gastric mobilization or no ope rative procedure. Gastric acid output was measured by an aspiration te chnique, liquid gastric emptying was calculated by the double sampling technique of George, and gastroesophageal reflux was assessed by 8-h ambulatory pH monitoring. Laparoscopic HSV was as effective as its ope n counterpart in reducing basal acid output, and laparoscopic HSV did not interfere with liquid gastric emptying in contrast to open HSV. Ne ither open nor laparoscopic HSV was observed to precipitate gastroesop hageal reflux, These data suggest that the continued use of laparoscop ic HSV in clinical practice is appropriate.