Lesser gastric curvature and fundus myotomy. Experimental and clinical studies.

To eliminate successfully the undesirable side effects of the highly selective vagotomy, we developed a new, simpler type of vagotomy. As it was thoroughly demonstrated in dogs, myotomy of the lesser gastric curvature and fundus of the stomach denervates the parietal cell mass. Preoperative and postoperative acid studies were carried out with histamine phosphate (0.4 mg/kg given intramuscularly) and insulin injection (0.2 units/kg given intravenously). After myotomy, the curve was shifted to the right in response to histamine; insulin response was completely abolished. These results provided the basis for the treatment of duodenal ulcer in a human patient and confirmed that the operation is capable of producing satisfactory secretory inhibition. Our early experimental and clinical results have been encouraging. Therefore, we support further investigation regarding clinical application of this method in the treatment of chronic duodenal ulcers.