Vagus nerve amputation

The cause of ulcer disease is relatively complicated, which is caused by the comprehensive effect of many factors, but mental and neurological factors play a major role. The stress and stimulation caused by various reasons can make the brain over-excited or fatigued, so that the cortex and the subcortical center are out of coordination, and then cause autonomic dysfunction, which is manifested as abnormal vagus nerve function. It is generally believed that vagus nerve functional fiber function is low in patients with gastric ulcer, causing pyloric spasm, stagnation of the sinus, and gastric acid secretion in the sinus phase; in patients with duodenal ulcer, the vagus nerve function is often hyperactive, causing the release of acetylcholine and directly stimulating gastric wall cells Produce stomach acid. At the same time, the vagus nerve excitement also stimulates the sinuses, causing the vagal-sinus phase to promote gastrin secretion, which indirectly produces gastric acid. The sinus can also be stimulated by food and alkaline mucus to secrete gastrin, causing gastric acid secretion in the local antrum phase. According to the above point of view, many medical workers have advocated the use of vagus nerve cuts to treat duodenal ulcers for many years, which can reduce gastric acid and reduce recurrence of ulcers, and avoid complications after subtotal gastrectomy, such as small stomach symptoms and malnutrition. . For patients with gastric ulcers, local gastric antrum secretion is the main manifestation, and gastric acid is not very high. Therefore, it is advisable to simply remove the sinus or perform a semi-gastrectomy without cutting the vagus nerve. Vaginal sectomy for duodenal ulcer cannot be performed as an independent operation. It must be combined with gastric drainage or partial gastrectomy to achieve effective treatment. Additional gastric operations include gastrojejunostomy, pyloroplasty, antrum resection, and hemi-gastrectomy [Figure 1 ⑴ ～ ⑷].