<s>[INST] context: 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 [/INST] question: Nerves of latarjet are spared in | options: A: Highly selective vagotomy B: Vagotomy and antrectomy C: Vagotomy and Drainage D: truncal Vagotomy | answer: A </s>