Abstract“Highly selective” or “proximal gastric” vagotomy seeks to denervate the pariental cell mass of the stomach while preserving the innervation of the pyloric antrum, and is now frequently used in the surgical treatment of duodenal ulceration. However, a high incidence of recurrent ulceration after highly selective vagotomy has been reported, suggesting inadequate denervation of the parietal cell mass. This study aims to examine the innervation of the distal parietal cell mass by antral nerves and their possible role in recurrent ulceration after highly selective vagotomy.The distribution of the nerves supplying the pyloric antrum, distal to the termination of the nerve of Latarjet, was compared to the pariental cell boundary in 20 stomachs.Parietal cells extended all the way to the distal pylorus in 35% of stomachs and could potentially have been innervated by antral branches in 55%. Branches from the anterior vagal trunk terminated on the posterior antral surface in 25% of stomachs and from the posterior trunk on the anterior surface in 20%.These findings suggest that there may be an anatomical limitation to complete denervation of the distal pariental cells mass during a standard highly selective vagotomy where the nerve of Latarjet and all the branches distal to it are