Transgastric highly selective vagotomy (HSTRV) without drainage. Preliminary report of a new simplified procedure of treatment of duodenal ulcer.

The technique of preserving the antral vagal nerve supply of the stomach and division of the gastric branches of the nerves of Latarjet is common to both operations, but by replacing the transection of the hiatal cardioesophageal vagus nerve branches (including the nerve branches accompanying the arteries entering the fundus of the stomach) with a transgastric intramural transection and excision of all nerve fibers entering the fundus, a highly selective vagotomy is achieved. Completeness of HSTRV is controlled intraoperatively by a gastric pH meter and by measuring the oxygen tension of the gastric mucosa. One year to 18 months after application of HSTRV in 74 patients with uncomplicated duodenal ulcers, mortality was nil, morbidity insignificant, the previous ulcer symptoms no longer present, and dumping syndrome, recurrence and other significant complications were not observed.