Abstract

Dr. Asif Afsar and Dr. Purujit Choudhury*

ABSTRACT

A prospective clinical study on choleakinesia following total vagectomy (Bilateraltruncal vagotomy) was carried out during the period from April 2016 to December2020. Total 55 cases were studied who was suffering from chronic duodenal ulcer.Out of these total 55 cases fifteen cases had gastric outlet obstruction with hugelydilated stomach which was considered as control group in this study. Other 40 caseswere considered as study group. Truncal vagotomy with retrocolic isoperistalticGJA done in study group and only retrocolic isoperistaltic GJA operation done incontrol group. Two patients had incomplete vagotomy. All the patients weremale and average age was 38.1 years.32.7% cases were belonging to the age groupbetween 26-35 years which was the highest. Though the cases were operated tillSeptember 2020, they were followed up till December2023.Gastric acidity, oralcholecystography and ultrasonography of upper abdomen was done in both pre andpost operative period. All cases were meticulously examined to exclude otherassociated pathology. Cases were diagnosed by Barium meal and clinicalanalysis.14 days post- operatively gastric acid analysis and three months postoperativelyoral cholecystography was done. In the post-operative follow up periodultrasonography upper abdomen was done. 39 (71%) patients were turned up forcheck up in post-operative period out of which 29 patients belong to completevagotomy group. In conclusion it was seen that following total vagotomy thecontraction of gall bladder was definitely reduced with decrease % loss of bileresults stasis of bile. There was more than double dilatation of the gall bladder asdetected three months post-operatively after complete section of vagus. 7.5% ofpatients of complete vagotomy group developed gall stones till three to four yearspost-operatively and 20% patients developed minimal gall bladder sludge and 5%patients developed dense peripheral sludge with wall thickening till that period.Incomplete vagotomy and control group didn’t show such significant changes.More than 50% acidity was reduced following truncal vagotomy in fasting, basaland maximum acid output in both free and total state.