Die proximal-selektive Vagotomie in der Behandlung der gastroduodenalen Ulkuskrankheit

Martinoli, S

doi:10.1007/978-3-642-69596-4

Cited by 18 publications

(34 citation statements)

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“…The postoperative results after PGV depend largely on the quality and the thoroughness of the denervation. Studies by Kronberg et al [21 ] and Muller and Martinoli [28], as well as our own experience, have shown that vagotomy has two potential flaws, which arise from an imprecise denervation at the oral and aboral end of the preparation area. The dissection must extend for at least 6 cm to the esophagogastric junction.…”

Section: Duodenal Ulcersmentioning

confidence: 99%

“…The two authors showed that the recurrence rate was 20% versus 10% when only 2 cm were dissected instead of 6 cm. On the lesser curvature, the denervation must be extended to within 6 cm of the pylorus, and the two proximal branches of the Laterjet nerves must be severed [28], If the preparation is meticulous, the recurrence rate following PGV is 4-18% depending on the observation period. It is markedly better than the success rates of conservative therapy (table 3).…”

Section: Duodenal Ulcersmentioning

confidence: 99%

“…The further refinements of the vagotomy proce dures leading to the introduction of the proximal gastric vagotomy (PGV) have relegated the methods of gastric surgery involving resections to a secondary place. How ever, there are certain cases of ulcers such as gastric ulcers in which the long-term results of vagotomy do not fulfill the expectations [28,33]. As a consequence, it has been realized in recent years that peptic lesions require a differentiated pathophysiological analysis which then leads to a differentiated choice of surgical treatment from the spectrum available.…”

Section: Introductionmentioning

confidence: 99%

“…4). The reason for this is most probably the therapeutic fail ure of vagotomy in certain types of ulcers such as gastric ulcers [28,33,34,37], (4) The main reason for surgical therapy is to prevent duodenal ulcers from recurring.…”

Section: Introductionmentioning

confidence: 99%

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Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Schafmayer¹,

Köhler²,

Neufang³

1991

Dig Surg

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Section: Duodenal Ulcersmentioning

confidence: 99%

Section: Duodenal Ulcersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Schafmayer¹,

Köhler²,

Neufang³

1991

Dig Surg

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“…In the treatment of duodenal ulcer disease proximal gastric vagotomy (PGV) is burdened with recurrence rates of about 15% within 5 years according to prospec tive controlled studies [1,2], Up to now a preoperative identification of patients with increased risk for postop erative ulcer recurrence is not possible [1,[3][4][5][6].…”

mentioning

confidence: 99%

Experience with Long-Term Intragastric pH Monitoring as a Test after Proximal Gastric Vagotomy

Hölscher¹,

Bollschweiler²,

Seebauer³

et al. 1989

Dig Surg

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The aim of the present study was to determine the differences in gastric acidity between duodenal ulcer patients with and without recurrent ulceration after elective proximal gastric vagotomy (PGV). The pre- and postoperative results of 24-hour intragastric pH monitoring of 10 patients with ulcer relapse were compared to the data from a control group of 42 patients without recurrence. Patients with ulcer recurrence had a significantly (p < 0.05) lower median pH and a significantly (p < 0.05) higher median percentage of pH recordings of ≤ 2 during the postoperative sleep phase than patients without ulcer relapse. High nocturnal acidity seems to be a predisposing factor for the recurrence of ulcers after PGV. A risk group for ulcer recurrence after PGV is defined by a postoperative median pH of ≤ 2.0 and a median percentage of pH readings of ≤ 2 of more than 70% during the sleep phase. The sensitivity and specificity of postoperative intragastric pH monitoring for identification of this at-risk group was 80 and 91 %, respectively.

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Anterior lesser curve seromyotomy with posterior truncal vagotomy versus proximal gastric vagotomy

Oostvogel

1988

Journal of British Surgery

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In a prospective randomized trial anterior lesser curve seromyotomy with posterior truncal vagotomy (ASPTV, n = 48) has been compared with proximal gastric vagotomy (PGV, n = 43). Eighty-eight and eighty-three patients were available for follow-up studies at 1 year and 2 years, respectively. Six months postoperatively the mean reduction in pentagastrin-stimulated peak acid output (PAO) was 48.5 per cent (s.d. 26.3) after PGV and 50.5 per cent (s.d. 23.3) after ASPTV. Two years after the operation satisfactory clinical results (Visick I + II) were found in 84.2 per cent of the patients after PGV and in 88.9 per cent after ASPTV. There was a significant difference in the duration of surgery. No serious postoperative gastric sequelae were encountered after either operation. Up till January 1987, eight endoscopically proven, symptomatic recurrent ulcers have been diagnosed: four in the PGV group (9.3 per cent) and four in the ASPTV group (8.7 per cent). The results of this randomized study suggest that ASPTV is as good as PGV in the surgical treatment of chronic duodenal ulcers.

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Die proximal-selektive Vagotomie in der Behandlung der gastroduodenalen Ulkuskrankheit

Cited by 18 publications

References 0 publications

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Experience with Long-Term Intragastric pH Monitoring as a Test after Proximal Gastric Vagotomy

Anterior lesser curve seromyotomy with posterior truncal vagotomy versus proximal gastric vagotomy

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