Differences in gastric emptying between highly selective vagotomy and posterior truncal vagotomy combined with anterior seromyotomy

Gastric emptying has been reported to be both delayed and unchanged followi ng posterior truncal vagotomy combined with anterior seromyotomy (PTV + AS) . When compared to highly selective vagotomy (HSV), our clinical experience was that PTV + AS not uncommonly produced postprandial distress. We studie d gastric emptying of both liquids and solids 3 and 12 months following HSV and PTV + AS to determine what if any differences there were in gastric em ptying between the two procedures, We compared these results with those fro m studies done in both normal subjects and unoperated duodenal ulcer patien ts. In 26 duodenal ulcer patients with perforation (n = 18) or bleeding (n = 8), who were treated with HSV (n = 10) or PTV + AS (n = 16), gastric empt ying of liquids and solids was evaluated at 3 months and 12 months postoper atively. At 3 months, gastric emptying of liquids was delayed in both the H SV and PTV + AS groups as compared to values in both normal subjects and un operated duodenal ulcer patients. The emptying of solids was markedly delay ed by PTV + AS in contrast to HSV at 3 months (167.1 +/- 28.4 minutes vs. 7 9.9 +/- 16.7 minutes; P <0.05). The lag duration was not affected. A limite d number of patients studied at 12 months showed similar and near-normal em ptying of solids in both the HSV and PTV + AS groups (67.5 +/- 7.0 minutes vs, 70 +/- 6.6 minutes). PTV + AS in contrast to HSV produces more marked d elayed emptying of liquids and solids at 3 months; with time (1 year) these values return to near normal.