Indications for Conservative Surgery in Gastric Ulcer

Lewis, A. A. M.; Qvist, George

doi:10.1111/j.1742-1241.1971.tb09240.x

Cited by 5 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…over men in the ratio of 2.1:1. Others [3,4] also describe a higher incidence among women and this corresponds to reports of an increasing incidence of perforated gastric ulceration in women while the incidence in men is tending to fall [5,6]. In one series, however [7], the HGU patients were mostly men.…”

Section: Discussionsupporting

confidence: 64%

“…The mean age of our patients was 66 years and 20% of them were older than 75 years. Others [4] also quote that most of their patients with HGU were old, possibly because the site of prediliction of gastric ulcers, the antrum-corpus junction, moves proximally with increasing age [8,9]. This large number of old patients contributed to the fact that almost half of our patients had diseases in other organ systems and were poor operative risks.…”

Section: Discussionmentioning

confidence: 89%

“…Others found that 25-50% of their patients with HGU had concomitant signs or previous symptoms of duodenal ulcers [7,8,19]. This is somewhat in contradiction to the statement [4,8] that all patients with HGU have hypoacidity.…”

Section: Discussionmentioning

confidence: 92%

“…It was done in 3 elective patients in our series with no mortality or recurrence. If vagotomy is done alone without excision, the chances of missed malignancy and recurrence or a benign ulcer increase [4,24,30]. It should, however, be stressed again that excision ofa HGU is difficult or impossible and this was not attempted in our 3 patients.…”

Section: Vagotomy Alone (With or Without Drainage)mentioning

confidence: 91%

See 3 more Smart Citations

High gastric ulcer

1987

View full text Add to dashboard Cite

Fifty-six patients with high gastric ulcers were studied retrospectively. There were 38 women and 18 men. The mean age was 66 years. Findings were: 25% had ulcer histories of more than 5 years; 45% had illnesses in other systems making them poor operative risks; 34% were taking ulcerogenic drugs, and 36 % were on antiulcer treatment prior to surgery; 43% presented with severe bleeding, 16% with perforation, and 2 patients had simultaneous bleeding and perforation; 38% had deeply penetrating ulcers and many ulcers were very large; 7 patients had ulcers in hiatus hernias. Sixty-three percent of the procedures were emergencies. Half of the operations were nonresective, with or without vagotomy. The other half were gastric resections of various types. The overall mortality rate was 18%, but the mortality rate was 24% for emergency procedures and 9% for elective ones. The highest mortality rate, 45%, occurred after emergency resective procedures. Vagotomy did not increase postoperative mortality when added to a nonresective procedure. Beside the 10 patients who died, 6 others developed severe postoperative complications, usually respiratory failure or suture line leakage. Follow-up of between 6 months and 12 years (average 3 years) was possible in 55% of the patients. Two developed recurrent ulcers and 2 had overlooked gastric carcinomas. An approach of management for high gastric ulcer is outlined recommending a Pauchet operation for good-risk patients, and vagotomy and drainage for old and frail patients. Medical treatment should be pursued as long as possible to avoid an often hazardous operation.

show abstract

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 92%

Section: Vagotomy Alone (With or Without Drainage)mentioning

confidence: 91%

See 2 more Smart Citations

High gastric ulcer

1987

View full text Add to dashboard Cite

show abstract

Operative treatment of high gastric ulcer with special reference to Pauchet's method

Lewis

Qvist

1972

Journal of British Surgery

View full text Add to dashboard Cite

A high gastric ulcer may be treated by excision, or the ulcer may be retained and healing encouraged by other means. If the ulcer is retained there is a small but definite risk of malignancy. Neither gastric drainage, nor the Kelling–Madlener operation, nor vagotomy and pyloroplasty ensures healing in a high gastric ulcer. Local wedge resection of the ulcer is attended by very poor results, and a high mortality and morbidity preclude the use of subtotal or total gastrectomy. Pauchet's procedure combines the advantages of limited gastrectomy and gastroduodenal anastomosis with complete removal of the ulcer. It is the recommended operation for high gastric ulcers.

show abstract

Vagotomy and pyloroplasty in the elective treatment of gastric ulcer

Lawson

Hutchison

1973

Journal of British Surgery

View full text Add to dashboard Cite

Vagotomy and pyloroplasty have been used in the elective treatment of gastric ulcer in 72 patients. In 33 patients there was associated duodenal ulcer (G.D.U.). In the other 39 patients (G.U.) there was no evidence of duodenal ulcer. Patients with prepyloric gastric ulcer were excluded. The operative mortality was nil. At an average follow‐up of 3 1/2 years the functional results in the G.U. group were good for 89 per cent of the cases, satisfactory for 5‐5 per cent, and poor for 5‐5 per cent compared with 73, 10, and 17 per cent respectively in the G.D.U. group. Two patients in each group showed recurrent ulcer, an incidence of 5‐4 per cent in the G.U. group and 6‐7 per cent in the G.D.U. group. There is no statistically significant difference in these results. Vagotomy and pyloroplasty appear to comprise a satisfactory treatment for gastric ulcer whether or not the ulcer is associated with duodenal ulcer. The present findings do not support the view that the good results previously reported were due to the inclusion of patients with pre‐pyloric gastric ulcer or with associated duodenal ulcer. Three patients showed malignancy in the ulcer and a further case has been recorded in the total of 102 patients undergoing surgery during the period of the review (an incidence of 4 per cent), underlining the need for biopsy of the ulcer in all cases.

show abstract

Indications for Conservative Surgery in Gastric Ulcer

Cited by 5 publications

References 38 publications

High gastric ulcer

High gastric ulcer

Operative treatment of high gastric ulcer with special reference to Pauchet's method

Vagotomy and pyloroplasty in the elective treatment of gastric ulcer

Contact Info

Product

Resources

About