Cholecystectomy and truncal vagotomy with pyloroplasty. The effect on duodenogastric reflux.

An experimental study investigated the effect of truncal vagotomy and pyloroplasty (TV + P) alone or combined with cholecystectomy on bile reflux into the stomach. The amount of bile reflux was estimated by measuring the concentration of bile phospholipids in the gastric contents. During each test, reflux was measured over a continuous period of 6 hours. TV + P alone was not invariably associated with increased reflux. When cholecystectomy was added to the TV + P the amount of bile reflux increased significantly (P less than 0.01). TV + P inhibited the production of lysolecithin from lecithin. Pathophysiologically this is important because lysolecithin is considered to be injurious to gastric mucosa.