Abstract

Dr. Abhijit Sarma and *Dr. Purujit Choudhury

ABSTRACT

A prospective clinical study on choleakinesia following total vagectomy (Bilateral truncal vagotomy) was carried out during the period from April 2010 to December 2016.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 hugely dilated stomach which was considered as control group in this study. Other 40 cases were considered as study group.Truncal vagotomy with retrocolic isoperistaltic GJA done in study group and only retrocolic isoperistaltic GJA operation done in control group. Two patients had incomplete vagotomy.All the patients were male and average age was 38.1 years.32.7% cases were belonging to the age group between 26-35 years which was the highest. Though the cases were operated till September 2016, they were followed up till December2016.Gastric acidity, oral cholecystography and ultrasonography of upper abdomen was done in both pre and post operative period. All cases were meticulously examined to exclude other associated pathology. Cases were diagnosed by Barium meal and clinical analysis.14 days post-operatively gastric acid analysis and three months post-operatively oral cholecystography was done. In the post-operative follow up period ultrasonography upper abdomen was done.39 (71%) patients were turned up for check up in post-operative period out of which 29 patients belong to complete vagotomy group. In conclusion it was seen that following total vagotomy the contraction of gall bladder was definitely reduced with decrease % loss of bile results stasis of bile. There was more than double dilatation of the gall bladder.[1,4] as detected three months post-operatively after complete section of vagus. 7.5% of patients of complete vagotomy group developed gall stones till three to four years post-operatively.[1] 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, basal and maximum acid output in both free and total state.