Vagotomy

Question 1

Truncal Vagotomy

Answer 1

• interruption of vagal trunk
  at esophageal hiatus. Denervates: Parietal
  cell mass, antral pump, pyloric sphincter,
  majority of abdominal viscera
  Must be combined with pyloroplasty,
  antrectomy and Billroth 1 or 2.

Question 2

Selective Vagotomy

Answer 2

Total denervation of stomach from above crus
of diaphragm including pylorus.
Spares parasymphathetic innervation of the
abdominal viscera
Must be combined with pyloroplasty,
antrectomy with Billroth 1 or 2

Question 3

Proximal(Parietal) Vagotomy

Answer 3

Interruption of branches of of vagus nerve along
lesser curvature
Denervates only parietal cell mass so antral
pump and pyloric sphincter continue to
function
Does not require gastric drainage procedure
Contraindicated by gastric outlet obstruction
secondary to peptic ulcers