Parietal cell vagotomy. Localisation of the microscopical antral-fundic boundary in relation to the macroscopical.

88 patients, operated upon for duodenal or prepyloric ulcers with a parietal cell vagotomy, were investigated in order to define the macro- and microscopical boundaries between the antrum and fundus of the stomach. The macroscopical boundary was defined as the point on the minor curvature where the nerve of Latarjet intersects the stomach or gives off its antral branches. The microscopical boundary was determined by taking multiple biopsies from both curvatures at distances related to the pylorus and to the nerve of Latarjet. At the minor curvature, the microscopical boundary was found to be located within +/- 2 cm from the macroscopical in 93% of the cases. The distance between the microscopical antralfundic boundary and the pylorus was significantly greater (8.7 +/- S.D. 1.6 cm) on the minor curvature than on the major (7.5 +/- 1.8 cm). In terms of optimal, over- and underdenervation on the minor curvature, 47% were optimal, 24% over- and 25% underdenervated. In 4 cases the boundary was indeterminable. This underdenervation means an antomical limitation of the operation and is inevitable because further denervation would sever the innervation of the antrum.