Abstract
We performed laparoscopic gastric vagotomy by Taylor's procedure in a 19-year-old man with intractable duodenal ulcer which had recurred for 14 months despite administration of conservative anti-ulcer drugs including eithert H2 antagonist or proton-pump inhibitor. Our operative procedure and its results are reported as the first experience with laparoscopic vagotomy by Taylor's procedure in Japan. Through five trocars in the upper abdomen the peritoneal cavity was entered. First, the posterior vagal trunk was doubly clipped to divided it. Then anterior lesser curve seromyotomy was carried out to dissect the anterior fundic branches, beginning at the Crow's foot, coursing parallel to the lesser curve at 1.5 cm from its border and finishing at the angle of His. The wound after seromyotomy was closed by suturing. The operation took 3 hours and 30 minutes. Postoperative endoscopic observation showed complete healing of the ulcer and well preserved gastric emptying function. Acid reduction rate was 93.3% in BAO and 88.3% in MAO.
