This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Nerves of latarjet are spared in \nSelect and explain. \nA. Highly selective vagotomy, B. Vagotomy and antrectomy, C. Vagotomy and Drainage, D. truncal Vagotomy', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Types of vagotomy\n\nHighly selective vagotomy (HSV)\nVagotomy and drainage (V+D)\nVagotomy and antrectomy (V+A)\n\nVagotomy is a component of each of these procedures. It decreases the acid secretion by stopping cholinergic input into the stomach.\nBut since vagus nerve is also the motor supply of stomach and the antropyloroduodenal segment a truncal vagotomy leads to gastric stasis.\nGastric stasis is prevented by adding a drainage procedure to the truncal vagotomy (Vagotomy & drainage - V+ D).\nDrainage procedure used are :\n\nGastrojejunostomy\nPyloroplasty\n\n\nIn 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.\n\nThis preserves gastric motility\nAdvantages\n\nTechnical simplicity & preservation of entire gastric reservoir capacity.\nLowest mortality and side effects\nMinimal chances of dumping syndrome\n\nDisadvantage\n\nRecurrence rates are higher than V + D or V + A.\n\nVagotomy plus antrectomy\n\nIn 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.\n\nAdvantages - lowest recurrence rate\nDisadvantage - high mortality & morbidity', 'role': 'assistant'}]