Operative treatment of recurrence after vagotomy and drainage for duodenal ulcer, gastric ulcer, and acid dyspepsia without ulcer

Johnson, Jon A.; Giercksky, Karl Erik

doi:10.1007/bf01565920

Cited by 4 publications

(3 citation statements)

References 8 publications

(13 reference statements)

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Section: Resultssupporting

confidence: 73%

“…The patients underwent operative were operated on during the first year, 9 in the second, 3 in the third, 2 in the sixth, and 1 in the seventh year. Our results of operative treatment for recurrent ulcers after vagotomy have been reported previously [10]. Table 3 shows the relationship between reduction of pentagastrin-stimulated or histamine-stimulated gastric acid secretion and insulin-stimulated secretion after vagotomy.…”

Section: Resultsmentioning

confidence: 52%

“…Retrosternal "burning" was a complaint in 6% of the patients in the successful group. We have also seen 2 patients who developed esophagitis after revagotomy for duodenal ulcer [10]. Thus, it seems that selective vagotomy sometimes is associated with insufficiency of the lower esophageal sphincter, which in rare cases may lead to serious complications.…”

Section: Discussionmentioning

confidence: 96%

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Gastric ulcer treated with ulcerectomy, vagotomy, and drainage

Johnson

Giercksky

1980

World j. surg.

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This is a report of 152 patients with gastric ulcer treated by ulcerectomy, vagotomy, and drainage. In the series, 123 patients were operated on electively and 29 were operated on acutely for bleeding, with operative mortality rates of 1.3% and 6.9%, respectively. The operative mortality rate for the whole series was 2.6%. Of 144 patients followed up, 94 were cured and 25 were improved. The remaining 25 patients were reoperated on, 20 for recurrent ulcer, 2 for early postoperative gastric retention, 2 for dumping and reflux gastritis, and 1 for stenosing ulcer in the esophagus. In the group of 119 successfully treated patients, moderate side effects were observed, including diarrhea in 5.2% and dumping in 8.6%. In 26 patients, the mean reduction of histamine-stimulated or pentagastrin-stimulated acid output was 72.2% when the response to insulin stimulation was 0, 45.1% when the response to insulin was between 0 and 2 mEq acid per hour, and 12.4% when the response was higher. The frequency of positive insulin tests postoperatively was 77.8% among patients with recurrent ulcer, 40% among improved patients, and 10.8% among cured patients. Of 4 patients with ulcer recurrence and negative insulin tests, 3 had gastric retention and 1 hypergastrinemia.

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Section: Resultssupporting

confidence: 73%

Section: Resultsmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 96%

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Gastric ulcer treated with ulcerectomy, vagotomy, and drainage

Johnson

Giercksky

1980

World j. surg.

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Folgezustände nach Vagotomie

Zumtobel¹,

Wagner²

1980

Nichtresezierende Ulcuschirurgie

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Complications associated with ulcer recurrence following gastric surgery for ulcer disease

1992

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The present study is an attempt to assess the risks of the complications associated with recurrent ulcers in patients who have undergone gastric surgery and to determine whether these risks differ from those observed in patients receiving long term maintenance treatment with H2-receptor antagonists for ulcer disease. One hundred and thirty studies reported in the literature during the past three decades have been analysed to determine both the approximate rate of ulcer recurrence and the proportion of patients with recurrent ulcers who have presented with either haemorrhage or perforation following the various types of gastric surgery for ulcer disease. From these data, estimates of the risks of haemorrhage and of perforation during the years following gastric surgery have been calculated. Vagotomy and antrectomy is associated with a low risk of ulcer recurrence (less than 1%) and the risk of complications in later years is accordingly very small (less than 0.5%). Partial gastrectomy, although associated with low recurrence rates, has a higher risk of complications (1.3% for haemorrhage, 0.3% for perforation) because the proportion of recurrent ulcers that present with haemorrhage or perforation is high (33% and 8%, respectively). Truncal vagotomy plus drainage (TV + D) and highly selective vagotomy (HSV) are associated with recurrence rates of 9% and 12%, respectively, but ulcer recurrences following these operations are less frequently accompanied by complications then recurrences after gastric resection and, as a result, the risks of haemorrhage (1.7% for TV + D; 1.3% for HSV) are similar to the risks after gastric resection. During long term (five years or more) maintenance treatment with H2-receptor antagonists, the risks of haemorrhage and perforation are less than 2% and less than 0.5%, respectively. It appears, therefore, that the likelihood of developing haemorrhage or perforation following gastric surgery is of the same order as that during maintenance treatment with H2-receptor antagonists, at least during the first decade of follow-up.

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Operative treatment of recurrence after vagotomy and drainage for duodenal ulcer, gastric ulcer, and acid dyspepsia without ulcer

Cited by 4 publications

References 8 publications

Gastric ulcer treated with ulcerectomy, vagotomy, and drainage

Gastric ulcer treated with ulcerectomy, vagotomy, and drainage

Folgezustände nach Vagotomie

Complications associated with ulcer recurrence following gastric surgery for ulcer disease

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