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Recurrent ulcer after gastric surgery--prevention and management based on a local experience.
Ann Acad Med Singap. 1983 Oct; 12(4):564-9.AA

Abstract

This paper reports a personal experience in the management of 45 patients with recurrent ulcer after gastric surgery. Inadequate acid reduction was the major cause of ulcer recurrence and treatment was by further acid reduction. Revisional surgery was performed in 23 patients (including a patient with a gastro-jejuno-colic fistula) with one mortality. Preliminary results of therapy with histamine H2-receptor antagonists have been encouraging and there appears to be a reduced need for re-operation in these patients in recent years. Less common causes of ulcer recurrence include retained suture material (2 cases) and the Zollinger-Ellison syndrome (2 cases). The incidence of post-surgical ulcer recurrence may be reduced by: improved surgical techniques, particularly in the performance of vagotomy, and avoidance of operations without acid reducing procedures e.g., gastro-jejunostomy without vagotomy; wider use of emergency ulcer curative surgery for perforated peptic ulcer. Experience at two local centres has been that this is a safe procedure in selected patients, there being no mortality in 58 cases. Routine screening of peptic ulcer patients for the Zollinger-Ellison Syndrome by measuring the serum gastrin level facilitates early diagnosis of the condition, thus forestalling gastric surgery and the inevitable recurrent ulceration.

Authors

No affiliation info available

Pub Type(s)

Case Reports
Comparative Study
Journal Article

Language

eng

PubMed ID

6146288

Citation

Ti, T K.. "Recurrent Ulcer After Gastric Surgery--prevention and Management Based On a Local Experience." Annals of the Academy of Medicine, Singapore, vol. 12, no. 4, 1983, pp. 564-9.
Ti TK. Recurrent ulcer after gastric surgery--prevention and management based on a local experience. Ann Acad Med Singap. 1983;12(4):564-9.
Ti, T. K. (1983). Recurrent ulcer after gastric surgery--prevention and management based on a local experience. Annals of the Academy of Medicine, Singapore, 12(4), 564-9.
Ti TK. Recurrent Ulcer After Gastric Surgery--prevention and Management Based On a Local Experience. Ann Acad Med Singap. 1983;12(4):564-9. PubMed PMID: 6146288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrent ulcer after gastric surgery--prevention and management based on a local experience. A1 - Ti,T K, PY - 1983/10/1/pubmed PY - 1983/10/1/medline PY - 1983/10/1/entrez SP - 564 EP - 9 JF - Annals of the Academy of Medicine, Singapore JO - Ann Acad Med Singap VL - 12 IS - 4 N2 - This paper reports a personal experience in the management of 45 patients with recurrent ulcer after gastric surgery. Inadequate acid reduction was the major cause of ulcer recurrence and treatment was by further acid reduction. Revisional surgery was performed in 23 patients (including a patient with a gastro-jejuno-colic fistula) with one mortality. Preliminary results of therapy with histamine H2-receptor antagonists have been encouraging and there appears to be a reduced need for re-operation in these patients in recent years. Less common causes of ulcer recurrence include retained suture material (2 cases) and the Zollinger-Ellison syndrome (2 cases). The incidence of post-surgical ulcer recurrence may be reduced by: improved surgical techniques, particularly in the performance of vagotomy, and avoidance of operations without acid reducing procedures e.g., gastro-jejunostomy without vagotomy; wider use of emergency ulcer curative surgery for perforated peptic ulcer. Experience at two local centres has been that this is a safe procedure in selected patients, there being no mortality in 58 cases. Routine screening of peptic ulcer patients for the Zollinger-Ellison Syndrome by measuring the serum gastrin level facilitates early diagnosis of the condition, thus forestalling gastric surgery and the inevitable recurrent ulceration. SN - 0304-4602 UR - https://www.unboundmedicine.com/medline/citation/6146288/Recurrent_ulcer_after_gastric_surgery__prevention_and_management_based_on_a_local_experience_ L2 - https://medlineplus.gov/pepticulcer.html DB - PRIME DP - Unbound Medicine ER -