Follow‐up of 100 patients five to eight years after parietal cell vagotomy

Jensen, Hans Grinsted; Amdrup, E

doi:10.1007/bf01563693

Cited by 46 publications

(15 citation statements)

References 11 publications

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“…Later studies showed considerable sequelae [13][14][15] appearing in the early postoperative years, but only few have described the long-term (i.e., 20-30 years) results [16][17][18][19][20]. The operative complications and mortality rate were not higher than in other gastrectomy studies [9,18,19,[21][22][23], but these should be compared to less extensive procedures such as vagotomy [1,24]. It is striking that the operative deaths were unpredictable and occurred even in young people; 50% of the deaths were patients less than 50 years of age.…”

Section: Discussionmentioning

confidence: 99%

Twenty‐five years after Billroth II gastrectomy for duodenal ulcer

Fischer¹

1984

World j. surg.

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One thousand twenty‐five patients underwent a Billroth II resection for duodenal ulcer between 1948 and 1956. The operative mortality rate was 2.4%. At follow‐up between 22 and 30 years later, 522 had died and 423 patients were traced. Recurrent ulcer appeared in 2.6% of the cases. Postgastrectomy symptoms occurred with the following frequency: dumping 10%, diarrhea 5%, vomiting 7%, and pain 4%. Anemia developed in 18%, hypoalbuminemia and hypocalcemia in 40 and 15%, respectively. Eleven percent had lost more than 10 kg in weight. Tuberculosis was found in 3% of the cases. While 90% of the patients were satisfied with the result, 10% were failures. The overall mortality rate was significantly increased because of suicide. Gastric carcinoma was the cause of death no more often than expected.

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Section: Discussionmentioning

confidence: 99%

Twenty‐five years after Billroth II gastrectomy for duodenal ulcer

Fischer¹

1984

World j. surg.

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“…The high recurrence rate, however, suggests that these ulcers have a special status. Numerous studies by other authors sup port this view [1,11,12,18,19,25,40].…”

Section: Results From Our Hospitalmentioning

confidence: 87%

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Schafmayer¹,

Köhler²,

Neufang³

1991

Dig Surg

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“…Only one study [14] showed a high recurrence rate of 23% eight years after operation. Compared to long-term results of proximal gastric vagotomy for duodenal ulcer (Table 3), similar recurrence rates are noted [4,[16][17][18][19][20][21][22][23][24][25].…”

Section: Recurrent Peptic Ulcer After Pgv With Ulcer Excisionmentioning

confidence: 79%

Recurrence after proximal gastric vagotomy for gastric, pyloric, and prepyloric ulcers

Heberer

Teichmann

1987

World j. surg.

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Results after proximal gastric vagotomy (PGV) with ulcer excision for gastric ulcer type I (according to Johnson) show recurrence rates similar to those for duodenal ulcer. In the European Multicenter Trial with 71 patients, symptomatic recurrence was 7.9% at 5 years and the total recurrence (including asymptomatic recurrences) was 17.5%. Recurrent ulcers are mainly gastric ulcers. Treatment of recurrence is, initially, always conservative with antacids or H2-receptor blockers. From 19 patients with recurrent ulcer after PGV with ulcer excision for gastric ulcer type I reported from 3 prospective trials, 12 were managed conservatively. The operative procedure of choice for recurrence was partial gastric resection with a Billroth I or Billroth II reconstruction. Favorable results for this type of gastric ulcer after PGV may be explained by maintenance of gastric continence for solids, reduction of duodenogastric reflux and of postoperative gastritis. Preoperatively and intraoperatively, malignancy has to be excluded by multiple biopsies and frozen sections. Combined gastric and duodenal ulcers (gastric ulcer type II) may also he treated by PGV in controlled trials so that more data will be available for that rare type of ulcer. Recurrence rates after PGV for pyloric and prepyioric ulcers (gastric ulcer type III) are significantly higher than those for gastric ulcer type I or duodenal ulcers. After 5 years, recurrence rates of 16.4-35% are reported. This may be due to gastric retention, which is a common feature in patients with prepyloric ulcers. In fact, selective gastric vagotomy and drainage or vagotomy and antrectomy give significantly better results. The operation rate for recurrent ulcers after pyloric and prepyloric ulcers following PGV is about 25% because of pyloric stenosis. It is concluded that PGV and ulcer excision seem to be suitable for gastric ulcer type I and probably for type H. Pyloric and prepyloric ulcers should no longer be treated by PGV alone because of high recurrence rates. A drainage procedure should be added. In general, the operation should be performed by experienced surgeons since recurrence rates depend on the number of surgeons involved in cliulcal trials.It is well established that the only significant postoperative morbidity following proximal gastric vagotomy without pyloroplasty (PGV) for gastroduodenal ulcer disease is ulcer recurrence [1][2][3][4]. Virtually 5 years after PGV, the Visick grade pattern is almost identical with that of blood donors serving as healthy controls [5]. PGV without a drainage procedure was first introduced for treatment of gastric ulcers by Johnston et al. [6]. To evaluate the results of PGV for benign gastric ulcer disease, it is absolutely mandatory to define the type of the

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Follow‐up of 100 patients five to eight years after parietal cell vagotomy

Cited by 46 publications

References 11 publications

Twenty‐five years after Billroth II gastrectomy for duodenal ulcer

Twenty‐five years after Billroth II gastrectomy for duodenal ulcer

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Recurrence after proximal gastric vagotomy for gastric, pyloric, and prepyloric ulcers

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