The congo red test to determine completeness of vagotomy: clinical application.

Over the past 5 years, we have evaluated the Congo red test for vagal competence as to its reliability under varied clinical conditions both intraoperatively and postoperatively. Our technique has been useful and accurate in approximately 200 patients. Insuring completeness of vagotomy during the operation has been of use in 42 patients uncovering an unsuspected incomplete vagotomy in 4. In a series of 31 patients with recurrent ulcer symptoms, the documentation of the cause as well as the presence of the ulcer is possible with one simple maneuver--endoscopy. Furthermore, the test has been utilized postoperatively in over 100 patients to determine the longevity of a negative test as well as the clinical sequelae of apositive study. With a trend to more selective vagal section and a continuing significant incidence of recurrent ulceration, we are convinced that the congo red test is an important adjunct to the surgical care of ulcer patients.