Precise antrectomy

Jensen, Hans -Eric; Badskjaer, Jørn; Andersen, Bjørg Marit; Johansen, Å.

doi:10.1007/bf01654813

Cited by 9 publications

(1 citation statement)

References 16 publications

(19 reference statements)

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“…The mean age of our patients was 66 years and 20% of them were older than 75 years. Others [4] also quote that most of their patients with HGU were old, possibly because the site of prediliction of gastric ulcers, the antrum-corpus junction, moves proximally with increasing age [8,9]. This large number of old patients contributed to the fact that almost half of our patients had diseases in other organ systems and were poor operative risks.…”

Section: Discussionmentioning

confidence: 91%

High gastric ulcer

1987

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Fifty-six patients with high gastric ulcers were studied retrospectively. There were 38 women and 18 men. The mean age was 66 years. Findings were: 25% had ulcer histories of more than 5 years; 45% had illnesses in other systems making them poor operative risks; 34% were taking ulcerogenic drugs, and 36 % were on antiulcer treatment prior to surgery; 43% presented with severe bleeding, 16% with perforation, and 2 patients had simultaneous bleeding and perforation; 38% had deeply penetrating ulcers and many ulcers were very large; 7 patients had ulcers in hiatus hernias. Sixty-three percent of the procedures were emergencies. Half of the operations were nonresective, with or without vagotomy. The other half were gastric resections of various types. The overall mortality rate was 18%, but the mortality rate was 24% for emergency procedures and 9% for elective ones. The highest mortality rate, 45%, occurred after emergency resective procedures. Vagotomy did not increase postoperative mortality when added to a nonresective procedure. Beside the 10 patients who died, 6 others developed severe postoperative complications, usually respiratory failure or suture line leakage. Follow-up of between 6 months and 12 years (average 3 years) was possible in 55% of the patients. Two developed recurrent ulcers and 2 had overlooked gastric carcinomas. An approach of management for high gastric ulcer is outlined recommending a Pauchet operation for good-risk patients, and vagotomy and drainage for old and frail patients. Medical treatment should be pursued as long as possible to avoid an often hazardous operation.

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Section: Discussionmentioning

confidence: 91%

High gastric ulcer

1987

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Antrectomy for recurrent ulcer after parietal cell vagotomy

Hoffmann

Meisner

1983

Journal of British Surgery

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The results of antrectomy for recurrent ulcer after parietal cell vagotomy are reviewed. Eighteen patients underwent precise antrectomy between 6 months and 7 years after their primary operation. Fourteen patients were reconstructed with a gastroduodenostomy and 4 with a gastrojejunostomy. Eighteen patients were available for follow-up of between 18 months and 10 years. One patient (6.25 per cent) developed a recurrent ulcer 1 year after antrectomy. There was no operative mortality. Six patients (33 per cent) had minor complications in the immediate postoperative period, and one (5.5 per cent) had a major complication. According to Visick grading, 75 per cent had good or excellent results and 25 per cent poor results. Antrectomy following parietal cell vagotomy can be achieved with a low operative mortality, a low ulcer recurrence rate and a satisfactorily low incidence of post-gastrectomy problems.

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Vagotomy or gastrectomy for elective treatment of benign gastric ulceration?

Greenall

Lehnert

1985

Digest Dis Sci

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The results of elective gastrectomy and vagotomy with drainage for benign gastric ulcer are described in terms of operative mortality, recurrent ulceration, overall clinical results, and risk of malignancy. Although it has a slightly lower operative morbidity and mortality, the results of vagotomy with drainage are not sufficiently superior to abandon gastrectomy. Highly selective vagotomy, without drainage, provides good overall clinical results but has a high associated incidence of recurrent ulceration. Neither gastrectomy nor vagotomy with drainage have a distinct advantage in patients with combined gastroduodenal or prepyloric ulceration.

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Precise antrectomy

Cited by 9 publications

References 16 publications

High gastric ulcer

High gastric ulcer

Antrectomy for recurrent ulcer after parietal cell vagotomy

Vagotomy or gastrectomy for elective treatment of benign gastric ulceration?

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