RESUMO
The authors relate about a pilot series of 100 controlled cases of duodenal ulcer, operated by means of a highly selective vagotomy without pyloroplasty. These patients, all followed during a mean period of 5 1/2 years, showed a recurrent ulcer rate of 5%. Literature studies indicate that, when one wants to improve the results of this operation, it is necessary to avoid a pyloroduodenal stenosis and to clear completely the esophagus over the distal 5 to 7 cm. The pH-measurements during operation seem to be of accessory importance. The duodenal ulcers with and without hypersecretion can be operated by means of a highly selective vagotomy with equal chances of healing.
Assuntos
Úlcera Duodenal/cirurgia , Vagotomia Gástrica Proximal , Vagotomia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Determinação da Acidez Gástrica , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Pentagastrina/uso terapêutico , Projetos Piloto , Piloro/cirurgia , RecidivaRESUMO
Hyperselective vagotomy is an operation to be performed with utmost care and necessitates control of the nerve ending during resection. The operation is extremely well tolerated and yields excellent results in simple duodenal ulcers. It is more delicate in perforated or bleeding ulcers. However one should ascertain the benign nature of the lesion and pathologic studies must be performed on frozen sections at the operation. Long term follow-up is not yet available.