Course and distribution of the glossopharyngeal, vagus, and accessory nerves.
See Types below for types/variations of vagotomy.
Truncal vagotomy is a treatment option for chronic duodenal ulcers. It was once considered the gold standard but is now usually reserved for patients who have failed the first-line "triple therapy" against Helicobacter pylori infection: two antibiotics (clarithromycin and amoxicillin or metronidazole) and a proton pump inhibitor (e.g., omeprazole). It is also used in the treatment of gastric outlet obstruction.
Vagotomy was once popular as a way of treating and preventing peptic ulcer disease and subsequent ulcer perforations. It was thought that peptic ulcer disease was due to excess secretion of the acid environment in the stomach, or at least that peptic ulcer disease was made worse by hyperacidity. Vagotomy was a way to reduce the acidity of the stomach, by denervating the parietal cells that produce acid. This was done with the hope that it would treat or prevent peptic ulcers. It also had the effect of reducing or eliminating symptoms of gastroesophageal reflux in those who suffered from it. The incidence of vagotomy decreased following the discovery by Barry Marshall and Robin Warren that H. pylori is responsible for most peptic ulcers, because H. pylori can be treated much less invasively. One potential side effect of vagotomy is a vitamin B12 deficiency. As vagotomy decreases gastric secretion, intrinsic factor production can be impaired. Intrinsic factor is needed to absorb vitamin B12 efficiently from food, and injections or large oral doses of the vitamin may be required after such a procedure in certain populations.
Other techniques focus on branches leading from the retroperitoneum to the stomach.
Highly selective vagotomy refers to denervation of only those branches supplying the lower esophagus and stomach (leaving the nerve of Latarjet in place in order to ensure the emptying function of the stomach remains intact). It is one of the treatments of peptic ulcer.
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- Research into 20 minute nerve cutting procedure results in average 18% weight loss
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- Vagotomy at the US National Library of Medicine Medical Subject Headings (MeSH)
- 00934 at CHORUS
- -939130865 at GPnotebook
- Overview and illustrations at surgeryencyclopedia.com
- Four types, at endoscopy-sages.com
- Overview at healthatoz.com
- News article — interview