Laparoscopic posterior truncal vagotomy and anterior highly selective vagotomy--a case report.

Laparoscopic vagotomy provides a viable alternative to expensive long-term treatment with H2 antagonists in patients with intractable peptic ulcer disease. The minimally invasive procedure offers reduced postoperative discomfort and improved cosmesis. Here, we report our first case of a posterior truncal vagotomy and anterior highly selective vagotomy performed laparoscopically for the first time in Asia. The surgery was uneventful. Diet was resumed on day 3 and the patient was discharged on day 4. Post-vagotomy acid secretion tests on the third week revealed a dramatic decrease in acid production. With further experience, laparoscopic vagotomy can be an attractive alternative to long term medication in peptic ulcer disease.