This monograph is a summary of observations collected over the past ten years on vagal denervation of the stomach and the functional pathology of the vagotomized stomach. It is primarily a continuation of the work we (Holle and Heinrich, 1954) began with fundectomy - the prototype of proximal dener vation of the stomach. This was the starting point for the develop ment of selective proximal vagotomy (SPV). Between 1961 and 1964 the SPY technique was developed to the extent that it could be applied clinically from January 1,1964. Like most clinical innovations, the development took place in several stages. A report on the first 235 surgical cases (1961-1967) appeared in 1968 in F. Holle's Special Surgery of the Stomach, pp. 508-509, and in 1969 in Surgery of the Stomach and Duodenum by Harkins and Nyhus, 2nd edition, pp. 629-634. Since that time it has been possible to demonstrate on the basis of 1200 operated cases as well as animal experiments that the new technique we introduced represents a successful, nonresecting surgical treatment of gastric and duodenal ulcers. It is important to have a long series of clinical cases from the same source, because it is not until a large number of individual observations have been collected concern ing complications of diagnosis, indications and technique that is it possible to analyse the relationships between them.
|Publisher:||Springer Berlin Heidelberg|
|Edition description:||Softcover reprint of the original 1st ed. 1974|
|Product dimensions:||6.69(w) x 9.61(h) x 0.02(d)|
Table of ContentsHistorical Outline.- Anatomy.- Functional Anatomy of the Vagus Nerves in the Upper Abdomen.- Comment I: Clinical Remarks on Vagal and Sympathetic Innervation of the Stomach.- Comment II: Vagal Effects on Bile Flow.- Comment III: Vagal Effects on Exocrine and Endocrine Pancreatic Secretion.- Histopathology.- Morphology of Gastric Parietal and Zymogen Cells.- The Gastrin Producing Cell.- The Effect of SPV on Parietal Cells in Man.- Changes in the Pyloric-Antral Nervous Tissue Accompanying Gastric and Duodenal Ulcers.- Physiology and Pathophysiology of the Vagus and Gastro-intestinal Hormones.- Gastric Acid Secretory Mechanisms.- Effects of Vagotomy on Gastric Acid Secretion.- Gastro-intestinal Hormones their Release and Influence on Secretion and Motility.- The Effect of Vagotomy on Circulating Gastrin.- Experimental Research on the Effects of SPV on Gastric Secretion and Motility in Animal and Man.- Effect of Proximal Gastric Resection (Fundectomy) on Gastric Secretion and Motility.- Effect of SPV on Gastric Secretion in Dogs in Insulin Tests and Sham Feeding.- Effect of Pyloroplasty on Gastric Secretion after SPV and SV in Dogs.- Effect of Exogenous Gastrin on the SP-Vagotomized Stomach in Man.- Significance of a Feeding Test with Check of Serum-Gastrin in Man and Dog.- Comment: Direct Measurement of Vagal Release of Gastrin.- The Effect of SPV and Pyloroplasty on Pepsin Secretion in Man.- Gastric Secretion and Motility after Highly Selective Sympathectomy.- Advances in Clinical and Experimental Studies on Vagotomy in Japan. Preface.- Indispensability of Vagal-Antral Rami for Preserving Gastric Motor Function after Vagotomy.- Effects of Various Types of Vagotomy with and without Pyloroplasty on Gastric Acid Secretion in the Dog.- Effect of SPV on Gastric Motility and Vitamin B12-Absorption in DU-Patients (Preliminary Report).- Functional Classification of Vagal Afferent Discharges in the Stomach of the Dog.- Acute and Long-term Effects of Vagotomy on Gastric Mucosal Blood Flow.- Comment: Oxygen Tension of the Canine Gastric Mucosa under the Influence of Vasoactive and Acid-Stimulating Agents Following Vagotomy.- Vagotomy and Cholelithiasis.- Regeneration of the Vagus Nerve.- Stress Ulcer and Unilateral Truncal Vagotomy.- Etiology of the Stress Ulcer.- Comment I: S-Gastrin in CNS-injuries.- Comment II: The Role of Histamine in Gastric Secretion and Stress.- Clinic of SP-Vagotomy.- Model of the Regulation of Secretion and Motility of the Stomach as a Feedback Circuit and its Practical Application.- Diagnostics and Indication.- Clinical Aspects of Vagotomy.- Nomenclature.- General Indication.- Case History and General Examination.- Pre- and Postoperative Secretory Tests.- Comment: Effect of SPV on Gastric Secretion as Determined by Insulintest in Man.- X-Ray Checks after SPV Combined with Various Drainage Operations.- Gastric Emptying after SPV.- Comment I: Studies on Gastric Emptying after Vagotomy.- Comment II: Sequence Scintigraphy for Measuring Gastric Emptying.- Special Indications for Operation and its Progress through SPV.- Duodenal Ulcer (DU).- Gastric Ulcer (GU).- Stress Ulcer.- Operating Technique of SPV.- Operating Technique of SPV and Pyloroplasty.- Principles and Pitfalls.- Standard Technique for SPV.- Intraoperative Tests for Improving the Technique of SPV and SV.- Test acc. to H. Burge.- Test acc. to G. Grassi.- Nervstaining acc. to Lee.- Marking of the Proximal Antral Border Line.- Operating Technique of Pyloroplasty.- Special Technique of Pyloroplasty (with Choice of Method).- Clinical Application of the Method of Operations Based on Form and Function.- Clinical Results.- Clinical Results. Current Procedures Combined with Vagotomy and Their Results.- Comment: Vagotomy and Antrectomy Revisited.- SPV and Pyloroplasty in Ulcer Disease.- Vagotomy in Ulcer Complications.- Perforation.- Bleeding Ulcer.- Recurrent Ulcer.- SPV in Hiatal Hernia.- SPV in Cardiospasm.- Postoperative Treatment and its Complications.- Critique and Summary.- References.- Complete Review of Literature to SPV and Pyloroplasty from F. Holle and Co-Workers 1954–1973.