The concept that the hypersecretion of gastric juices in gastroduodenal ulcer is largely neurogenic caused Dragstedt in 1943 to treat patients with intractable gastroduodenal ulceration by an operation designed to remove permanently and as completely as possible the vagus innervation of the stomach. The physiologic effect of the operation is both motor and secretory. Loss of motor function of the stomach is followed by atony and dilation. There is also a definite effect on the secretion, in most instances shown by histamine achlorhydria. The most striking effect of vagotomy on the patient with chronic peptic ulcer is the immediate and often dramatic relief of pain. The operation appears to be particularly indicated in patients who have had other surgical interventions such as pyloraplasty, posterior gastrojejunostomy or gastric resection and who have recurrent ulceration. Greatest success is noted in patients with marginal ulcer following partial gastric resection.
In a group of