Recurrences 1 to 10 Years after Highly Selective Vagotomy in Prepyloric and Duodenal Ulcer Disease

Adami, Hans‐Olov; Enander, L K; Enskog, Lasse; Ingvar, Christian; Rydberg, B

doi:10.1097/00000658-198404000-00004

Cited by 48 publications

(21 citation statements)

References 32 publications

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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: 86%

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Schafmayer¹,

Köhler²,

Neufang³

1991

Dig 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: 86%

Indication and Surgical Therapy in Uncomplicated Peptic Ulcer Disease

Schafmayer¹,

Köhler²,

Neufang³

1991

Dig Surg

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“…In this respect pH metry does not seem to lead further than preopera tive gastric secretion tests with stimulation by pentagastrin or sham feeding [3][4][5][6][7][8][9][10][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…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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“…Vagotomy still remains a standard treatment for peptic ulcer, and modified operations like highly selective vagotomy have a higher rate of recurrence (Adami et al, 1984;Stoddard et al, 1984). Even before the modification of vagotomies, it was proposed that surviving branches were able to re-innervate the glandular apparatus (Dragstedt et al, 1947).…”

Section: Introductionmentioning

confidence: 99%

An autoradiographic study of the distribution of the vagus nerve in the wall of the ferret stomach

Al-Muhtaseb

1993

Clinical Anatomy

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In this study, the normal distribution of the dorsal and ventral vagal trunks in the wall of the stomach of the ferret was investigated by the method of partial acute vagotomy and analyzed by light autoradiography. The dorsal trunk is distributed to the dorsal surface of the body and both surfaces of the pylorus. The ventral trunk reaches principally to the body of the ventral surface of the stomach. Three months after partial vagotomy, tritiated leucine was injected into the vagal dorsal motor nucleus to map any anatomical changes in the gastric distribution of each abdominal vagal trunk.Three months after dorsal trunk vagotomy, the ventral trunk invaded the territory of the dorsal trunk close to the lesser curvature of the body of the stomach by reactive sprouting. Three months after ventral trunk vagotomy, the dorsal trunk spread to innervate the ventral surface of the stomach that formerly was innervated by the ventral trunk.Three months after ventral trunk vagotomy, regrown connection of the ventral trunk was observed crossing over the ligature to the denervated areas of the ventral surface of the stomach. This result was observed in the three animals of chronic ventral vagotomy only, and the histological examination of the regrown connection showed that it was neuronal.This phenomenon of the compensatory reactive sprouting of the surviving vagal nerve terminals, whether regenerative or terminal, may explain the recovery of gastric function. This could account for some of the failures of partial vagotomy in humans.0 1993 Wiley-Liss, Inc.

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Recurrences 1 to 10 Years after Highly Selective Vagotomy in Prepyloric and Duodenal Ulcer Disease

Cited by 48 publications

References 32 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

An autoradiographic study of the distribution of the vagus nerve in the wall of the ferret stomach

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