Nerves of latarjet are spared in

Types of vagotomy Highly selective vagotomy (HSV) Vagotomy and drainage (V+D) Vagotomy and antrectomy (V+A) Vagotomy is a component of each of these procedures. It decreases the acid secretion by stopping cholinergic input into the stomach. But since vagus nerve is also the motor supply of stomach and the antropyloroduodenal segment a truncal vagotomy leads to gastric stasis. Gastric stasis is prevented by adding a drainage procedure to the truncal vagotomy (Vagotomy & drainage - V+ D). Drainage procedure used are : Gastrojejunostomy Pyloroplasty In Highly selective vagotomy (also known as parietal cell vagotomy or proximal gastric vagotomy) the vagal innervation to the antrum and pylorus (nerves of Latarjet) are preserved, only the vagal supply to the proximal two- thirds of the stomach (where essentially all the parietal cells are located) is cut. This preserves gastric motility Advantages Technical simplicity & preservation of entire gastric reservoir capacity. Lowest mortality and side effects Minimal chances of dumping syndrome Disadvantage Recurrence rates are higher than V + D or V + A. Vagotomy plus antrectomy In this operation, a distal gastrectomy (about 50% of the stomach) is done. This removes almost all the gastrin-producing mucosa, thus acid reduction is maximum in this operation. Advantages - lowest recurrence rate Disadvantage - high mortality & morbidity