Late results of bilateral selective vagotomy and pyloroplasty for duodenal ulcer: 5–9-year follow-up

Miguel, Jacinto De

doi:10.1002/bjs.1800610404

Cited by 19 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the calculations of the probabilities of ulcer recurrence, it might be expected that the recurrence rate will be 6% after SGV + D and 11% after PCV. The predicted recurrence rate for SGV + D is similar to the actual recurrence rate reported by other authors [5,6], so that it is probable that the predicted recurrence rate calculated for PCV represents a realistic guess for the future. The surgeon and the patient should then balance the higher recurrence rate after PCV against the lower rate of sequelae [1].…”

Section: Discussionsupporting

confidence: 83%

The aarhus county vagotomy trial

1978

View full text Add to dashboard Cite

In a prospective clinical trial, vagotomy for duodenal ulcer (DU) and prepyloric ulcer (PPU) was performed in 748 patients, 353 of whom were randomly allocated to selective gastric vagotomy and drainage (SGV + D), 54 to SGV + antrectomy (A), 273 to parietal cell vagotomy (PCV), and 68 to PCV + D. By 3 months postoperatively, basal acid secretion (BAO) had not stabilized. During the following year patients with SGV + A showed a decrease, while those with the other operations showed a rise in BAO, significant for SGV + D. One year after operation the level of BAO was the same after the 3 operations that did not remove the antrum. Peak acid output after pentagastrin stimulation (PAOPg) continued to decrease from 3 months to 1 year after SGV + A, while the other operations were followed by an increase, statistically significant for PCV. After 1 year the postoperative reduction in PAOPg was 90% for SGV + A, 45% for PCV, and approximately 60% for SGV + D and PCV + D. Overall clinical grading showed more failures following PCV than after SGV. Since failures after PCV were mainly ulcer recurrences, the final grading (after treatment of the failures) showed an equal number of failures for the 2 operations. Calculation of the probability of ulcer recurrence suggested a 6% rate after SGV + D and an 11% rate after PCV. However, when calculations took into account the location of the primary ulcer, the recurrence rate was the same after SGV + D for DU and PPU, while PCV showed a similar rate when used for DU but an incidence of 22% when used for PPU. The risk of recurrence was found to be constant from month to month during the first 2 1/2 years, after which no new recurrent ulcers were observed. It is suggested that for DU, PCV is preferable to SGV + D because the recurrence rate is the same but the incidence of sequelae is lower. When PCV is used for PPU, a higher ulcer recurrence rate may be expected.

show abstract

Section: Discussionsupporting

confidence: 83%

The aarhus county vagotomy trial

1978

View full text Add to dashboard Cite

show abstract

“…Other types of vagotomy may be rather similar. Five-year recurrence rates of 17% [16] and 8% [17] have been reported for SGV + D. Only for truncal vagotomy are real long-term studies available. Stempien et al [18] had a recurrence rate of 19% 5 years after truncal vagotomy and pyloroplasty, and 25% after 10 years.…”

Section: Discussionmentioning

confidence: 99%

The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage

et al. 1982

View full text Add to dashboard Cite

In a prospective, randomized study, 691 patients with duodenal (DU), pyioric (PU), or prepyloric (PPU) ulcers have been followed for 2-5 years after operation with parietal cell vagotomy (PCV) or selective gastric vagotomy with drainage (SGV + D). About half the patients have been followed for 5 years. Cumulative 5-year recurrence rates, calculated by a life table method, suggest a higher recurrence rate for patients with DU when operated with PCV (15%) than when operated with SGV + D (9%), but the difference was not statistically significant (p > 0.05). Patients with PU/PPU had higher recurrence rates following either procedure than patients with DU (PCV: 33%; SGV + D: 14%).A study of the change in recurrence risk as a function of time after operation suggests that the recurrence rate following SGV + D when used for DU will continue to rise after 5 years, but probably very slowly. The recurrence rate after 5 years is unpredictable, however, for PCV when used for DU, and unpredictable for both methods when used for PU/PPU.The recurrence rate was found to be independent of the level of preoperative gastric acid secretion, and this was true for both PCV and SGV + D. An increased recurrence rate was, on the other hand, found to be associated with < 50% postoperative reduction in pentagastrin-stimulated acid secretion.

show abstract

Recurrence of gastric ulcer after selective vagotomy and pyloroplasty for chronic uncomplicated gastric ulcer: A 5–10 year follow-up

Miguel¹

1975

Journal of British Surgery

Self Cite

View full text Add to dashboard Cite

Selective vagotomy and pyloroplasty were used in the surgical treatment of 73 patients with benign gastric ulcer between July 1964 and February 1970. Over the long period of observation recurrence of the gastric ulcer was found in 13 patients (19-1 per cent). This complication occurred equally commonly after treatment of primary and secondary gastric ulcers and was twice as frequent in women as in men. Possible reasons for these recurrences are discussed. It is concluded that vagotomy and pyloroplasty cure benign gastric ulcer in about 80 per cent of patients, and this should be taken into account in the choice of surgical treatment, especially in patients in whom a gastrectomy might put the patient's life at risk. However, because of the high recurrence rate, it is doubtful whether this operation should be considered the treatment of choice for all cases of gastric ulcer.

show abstract

Late results of bilateral selective vagotomy and pyloroplasty for duodenal ulcer: 5–9-year follow-up

Cited by 19 publications

References 38 publications

The aarhus county vagotomy trial

The aarhus county vagotomy trial

The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage

Recurrence of gastric ulcer after selective vagotomy and pyloroplasty for chronic uncomplicated gastric ulcer: A 5–10 year follow-up

Contact Info

Product

Resources

About