Highly selective vagotomy

Q) False about highly selective vagotomy
a) Highly selective vagotomy divides the vagus nerves supplying the acid-producing portion of the stomach
b) Incidence of postoperative complications is lower.
c) The criminal nerve of Grassi should be severed
d) Crow's feet nerves are severed till below the GE junction

 

 Ans -d

HSV only divides the last part of the nerves which supply the part of stomach which produces acid
Acnt and post nerves of Latarjet are found and their terminal branches are severed from 7 cm proximal to the pylorus to 5 cm above the GE junction
Motor function of the stomach is not affected
Criminal nerve of grassi is branch of posterior vagus. It should be sought and cut
Ref sab 2oth page 1206

Caustic injury esophagus

Q)  True statement about caustic injury esophagus :

A. NG tube is inserted to allow enteral nutrition.

B. Gastric conduit is preferred for esophageal reconstruction

C. Early dilatation to prevent stricture formation is not recommended

D. Contrast esophagogram is performed in the initial 48 hours to characterise the extent of injury and detect perforation

Achalasia pressures

Q All are true about achalasia except

A. Type 1 Achalasia is characterised by 100% failed contractions (DCI<100) and no esophageal pressurisation

B. Type 3 Achalasia has premature contractions in atleast 20% swallows

C. IEM (Ineffective esophageal motility) is characterised by >20% ineffective swallows (DCI<450)

D. Patients with type 2 achalasia have the best response to therapy