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Interpretation of postvagotomy endoscopic Congo red test results in relation to ulcer recurrence 5 to 12 years after operation.
Am J Surg. 1998 Jun; 175(6):472-6.AJ

Abstract

BACKGROUND

The aim of the present study was to estimate, after vagotomy, the location and extension of residual vagal innervation of the gastric corpus mucosa by using the endoscopic Congo red test (ECRT) and its relation to recurrent ulcer (RU), as well as the results of quantitative gastric acid tests: basal acid output (BAO), maximal acid output (MAO), and nocturnal acid output (NAO).

METHODS

A total of 271 consecutive vagotomized duodenal ulcer (DU) patients were studied 5 to 12 years (mean 8 years) after the operation. In all cases gastroscopy and ECRT were performed simultaneously. ECRT was considered positive if a red to black-blue (pH <3.0) color change of the gastric corpus mucosa occurred within the first 3 minutes, and the cases were classified as having small extension (SE), ie, one or more areas with a diameter of 1 to 30 mm, or large extension (LE), ie, 20% or more of the gastric corpus showing residual vagal innervation. No red to black-blue changes (pH >3.0) were attributed to negative ECRT. BAO, MAO, and NAO were determined preoperatively and postoperatively in 108 cases out of 271 and correspond with ECRT results.

RESULTS

Recurrent ulcer occurred in 18 out of 135 ECRT-positive and in 1 out of 136 ECRT-negative cases. RU occurred 5 times more frequently in LE than SE cases (P <0.05). The postoperative mean values of BAO, MAO, and NAO were significantly higher in ECRT-positive than in ECRT-negative cases (P <0.001), and higher in LE than in SE cases (P <0.01; for NAO, P >0.05).

CONCLUSION

ECRT is a practical and reliable method in the evaluation of postvagotomy DU patients: Negative ECRT practically includes recurrent ulcer risk; positive ECRT of large extension is related to fivefold higher recurrent ulcer risk compared with ECRT of small extension; and ECRT reflects BAO, MAO, and NAO results and can be used instead of them as a less time-consuming procedure, which is more convenient for the patient.

Authors+Show Affiliations

Department of Surgery, University of Tartu, Estonia.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9645775

Citation

Peetsalu, A, and M Peetsalu. "Interpretation of Postvagotomy Endoscopic Congo Red Test Results in Relation to Ulcer Recurrence 5 to 12 Years After Operation." American Journal of Surgery, vol. 175, no. 6, 1998, pp. 472-6.
Peetsalu A, Peetsalu M. Interpretation of postvagotomy endoscopic Congo red test results in relation to ulcer recurrence 5 to 12 years after operation. Am J Surg. 1998;175(6):472-6.
Peetsalu, A., & Peetsalu, M. (1998). Interpretation of postvagotomy endoscopic Congo red test results in relation to ulcer recurrence 5 to 12 years after operation. American Journal of Surgery, 175(6), 472-6.
Peetsalu A, Peetsalu M. Interpretation of Postvagotomy Endoscopic Congo Red Test Results in Relation to Ulcer Recurrence 5 to 12 Years After Operation. Am J Surg. 1998;175(6):472-6. PubMed PMID: 9645775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interpretation of postvagotomy endoscopic Congo red test results in relation to ulcer recurrence 5 to 12 years after operation. AU - Peetsalu,A, AU - Peetsalu,M, PY - 1998/6/30/pubmed PY - 1998/6/30/medline PY - 1998/6/30/entrez SP - 472 EP - 6 JF - American journal of surgery JO - Am J Surg VL - 175 IS - 6 N2 - BACKGROUND: The aim of the present study was to estimate, after vagotomy, the location and extension of residual vagal innervation of the gastric corpus mucosa by using the endoscopic Congo red test (ECRT) and its relation to recurrent ulcer (RU), as well as the results of quantitative gastric acid tests: basal acid output (BAO), maximal acid output (MAO), and nocturnal acid output (NAO). METHODS: A total of 271 consecutive vagotomized duodenal ulcer (DU) patients were studied 5 to 12 years (mean 8 years) after the operation. In all cases gastroscopy and ECRT were performed simultaneously. ECRT was considered positive if a red to black-blue (pH <3.0) color change of the gastric corpus mucosa occurred within the first 3 minutes, and the cases were classified as having small extension (SE), ie, one or more areas with a diameter of 1 to 30 mm, or large extension (LE), ie, 20% or more of the gastric corpus showing residual vagal innervation. No red to black-blue changes (pH >3.0) were attributed to negative ECRT. BAO, MAO, and NAO were determined preoperatively and postoperatively in 108 cases out of 271 and correspond with ECRT results. RESULTS: Recurrent ulcer occurred in 18 out of 135 ECRT-positive and in 1 out of 136 ECRT-negative cases. RU occurred 5 times more frequently in LE than SE cases (P <0.05). The postoperative mean values of BAO, MAO, and NAO were significantly higher in ECRT-positive than in ECRT-negative cases (P <0.001), and higher in LE than in SE cases (P <0.01; for NAO, P >0.05). CONCLUSION: ECRT is a practical and reliable method in the evaluation of postvagotomy DU patients: Negative ECRT practically includes recurrent ulcer risk; positive ECRT of large extension is related to fivefold higher recurrent ulcer risk compared with ECRT of small extension; and ECRT reflects BAO, MAO, and NAO results and can be used instead of them as a less time-consuming procedure, which is more convenient for the patient. SN - 0002-9610 UR - https://www.unboundmedicine.com/medline/citation/9645775/Interpretation_of_postvagotomy_endoscopic_Congo_red_test_results_in_relation_to_ulcer_recurrence_5_to_12_years_after_operation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002961098000713 DB - PRIME DP - Unbound Medicine ER -