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Surgical Treatment of Duodenal Ulcer Disease: A review and evaluation of methods F. Nagao 1 , T. Aoki 1 1The 2 nd Department of Surgery, Jikei University School of Medicine pp.823-829
Published Date 1978/6/25
DOI https://doi.org/10.11477/mf.1403107352
  • Abstract
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 This article is a review of the reports on various forms of surgical treatment of duodenal ulcer disease combined with presentation of our own experiences on a series of new method which is selective proximal vagotomy.

 The review w-as made mainly on foreign literature dealing with comparisons of the results following truncal vagotomy with drainage, truncal vagotomy with antrectomy, and partial gastrectomy. Additionally, selective vagotomy and truncal vagotomy have been compared along with various forms of drainage. In general the results of all current forms of elective surgery for chronic duodenal ulcer have been very good, and the differences among the effects of the various procedures have been small. There have been no significant differences in the mortality rates associated with the several operations when they have been performed electively. The rate of ulcer recurrence and incidence of diarrhea have been somewhat higher after truncal vagotomy with drainage, whereas the frequency of dumping and the amount of weight loss have been somewhat greater after all forms of gastric resection. Selective vagotomy appears to be associated with less frequent and severe diarrhea than truncal vagotomy. There have been no apparent differences in the results of the various drainage procedures that have been combined with vagotomy.

 Clearly, no single operation is best for all situations. Partial gastrectomy, which have been one of the major operations in Japan applied for gastroduodenal ulcers and occasionally accused to be followed by gastric cripple, can provides a lower ulcer recurrence rate and smaller postoperative side effects than vagotomy with drainage or antrectomy if some degree of selection is exercised.

 In Japan, it is stressed to improve further results in the treatment of duodenal ulcer that the operative indication should be expanded to duodenal ulcer patients with fewer episodes of recurrences and before development of complications which require emergency operations.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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