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Vagotomy without gastric drainage laparoscopic or thoracoscopic approach.
Hepatogastroenterology. 1999 May-Jun; 46(27):1494-9.H

Abstract

BACKGROUND/AIMS

This article describes the surgical techniques and preliminary results of a prospective trial of videoendoscopic bilateral truncal vagotomy without a drainage procedure in a series of selected patients with chronic non-obstructive intractible duodenal ulcer.

METHODOLOGY

Video laparoscopic and videothoracoscopic truncal vagotomy of chronic duodenal ulcer in 32 patients has been successfully performed in the Department of Surgery, Istanbul Medical Faculty Hospital. These patients undergoing bilateral truncal vagotomy (BTV) without a drainage procedure were chosen with selective indication regarding the absence of pyloric obstruction and presence of hyperacidity. Endoscopic pyloric balloon dilatation (PBD) was performed at the same stage with vagotomy only for 20 patients as a prospective trial. The results of acid secretory tests and endoscopic control were studied.

RESULTS

All the patients tolerated pure truncal vagotomy well under strict follow-up with semiliquid diet and promotility medication started 24 hours after surgery. The mean decrease in secretory tests for basal acid output (BAO) and peak acid output (PAO) were 70.6% and 79.5%, respectively. Endoscopic controls, 2 months after the operation, showed healing ulcers in patients who were able to be followed-up. One patient who had partial pyloric stenosis and was operated by BTV and PBD, required a drainage procedure in spite of repeated pyloric dilatation. During the mean follow-up period of 26 months (range: 10-46), the only symptom was moderate diarrhea in 4 patients, which became well with medical treatment or spontaneously.

CONCLUSIONS

Videoendoscopic truncal vagotomy seems to be an alternative treatment regimen for the management of chronic duodenal ulcer in a group of selected patients, as a simple, surgeon independent and efficient procedure. Instead of routine addition of a drainage procedure after truncal vagotomy, which may improve the morbidity, observation of the patient after truncal vagotomy with dietary caution supplementary to prokinetic medication may be the chosen method in some patients.

Authors+Show Affiliations

Department of Surgery, Istanbul Medical Faculty, Istanbul University, Turkey. odvim@turk.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10430283

Citation

Avci, C, et al. "Vagotomy Without Gastric Drainage Laparoscopic or Thoracoscopic Approach." Hepato-gastroenterology, vol. 46, no. 27, 1999, pp. 1494-9.
Avci C, Ozmen V, Avtan L, et al. Vagotomy without gastric drainage laparoscopic or thoracoscopic approach. Hepatogastroenterology. 1999;46(27):1494-9.
Avci, C., Ozmen, V., Avtan, L., Buyukuncu, Y., & Muslumanoglu, M. (1999). Vagotomy without gastric drainage laparoscopic or thoracoscopic approach. Hepato-gastroenterology, 46(27), 1494-9.
Avci C, et al. Vagotomy Without Gastric Drainage Laparoscopic or Thoracoscopic Approach. Hepatogastroenterology. 1999 May-Jun;46(27):1494-9. PubMed PMID: 10430283.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vagotomy without gastric drainage laparoscopic or thoracoscopic approach. AU - Avci,C, AU - Ozmen,V, AU - Avtan,L, AU - Buyukuncu,Y, AU - Muslumanoglu,M, PY - 1999/8/3/pubmed PY - 1999/8/3/medline PY - 1999/8/3/entrez SP - 1494 EP - 9 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 46 IS - 27 N2 - BACKGROUND/AIMS: This article describes the surgical techniques and preliminary results of a prospective trial of videoendoscopic bilateral truncal vagotomy without a drainage procedure in a series of selected patients with chronic non-obstructive intractible duodenal ulcer. METHODOLOGY: Video laparoscopic and videothoracoscopic truncal vagotomy of chronic duodenal ulcer in 32 patients has been successfully performed in the Department of Surgery, Istanbul Medical Faculty Hospital. These patients undergoing bilateral truncal vagotomy (BTV) without a drainage procedure were chosen with selective indication regarding the absence of pyloric obstruction and presence of hyperacidity. Endoscopic pyloric balloon dilatation (PBD) was performed at the same stage with vagotomy only for 20 patients as a prospective trial. The results of acid secretory tests and endoscopic control were studied. RESULTS: All the patients tolerated pure truncal vagotomy well under strict follow-up with semiliquid diet and promotility medication started 24 hours after surgery. The mean decrease in secretory tests for basal acid output (BAO) and peak acid output (PAO) were 70.6% and 79.5%, respectively. Endoscopic controls, 2 months after the operation, showed healing ulcers in patients who were able to be followed-up. One patient who had partial pyloric stenosis and was operated by BTV and PBD, required a drainage procedure in spite of repeated pyloric dilatation. During the mean follow-up period of 26 months (range: 10-46), the only symptom was moderate diarrhea in 4 patients, which became well with medical treatment or spontaneously. CONCLUSIONS: Videoendoscopic truncal vagotomy seems to be an alternative treatment regimen for the management of chronic duodenal ulcer in a group of selected patients, as a simple, surgeon independent and efficient procedure. Instead of routine addition of a drainage procedure after truncal vagotomy, which may improve the morbidity, observation of the patient after truncal vagotomy with dietary caution supplementary to prokinetic medication may be the chosen method in some patients. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/10430283/Vagotomy_without_gastric_drainage_laparoscopic_or_thoracoscopic_approach_ L2 - https://medlineplus.gov/endoscopy.html DB - PRIME DP - Unbound Medicine ER -