[Correlation between the anterior antral branches of the vagus nerve and the antral-fundic boundary in duodenal ulcer]

Abstract

The distances from the pylorus to the most proximal branch (proximal branch) and the most distal branch (distal branch) of the anterior antral branches were measured in 37 duodenal ulcer patients. The resected specimens were examined histologically to determine the antral-fundic boundary (F-line) and the distance from the pylorus to F-line was calculated. The distances from the pylorus to proximal branch, distal branch and F-line were 7.8 +/- 1.6 cm, 5.1 +/- 1.2 cm, 6.7 +/- 1.4 cm (M +/- SD), respectively. The mucosal area of proximal branch was fundic in 77% and pyloric in 23%. The mucosal area of distal branch was fundic in 14% and pyloric in 86%. There were three types of distribution of anterior antral branches in relation to F-line. In fundic type both proximal and distal branches intersect fundic mucosa. In ordinary type proximal branch intersects fundic mucosa whereas distal branch intersects pyloric mucosa. In pyloric type both proximal and distal branches intersect pyloric mucosa. The numbers of each type were 5(14%), 22(63%) and 8(23%), respectively. In conclusion, selective proximal vagotomy is not indicated for cases of fundic type in which the entire anterior antral branches intersect fundic mucosa.