PMID: 9438622Jan 23, 1998Paper

Video endoscopic truncal vagotomies without gastric drainage

Surgical Laparoscopy & Endoscopy
L AvtanY Büyükuncu

Abstract

The authors report 32 patients with chronic duodenal ulcer treated by bilateral truncal vagotomy (BTV) performed via laparoscopy or thoracoscopy. All cases were resistant to medical treatment and chosen with selective indication regarding endoscopic/radiologic and laboratory examination for absence of pyloric obstruction and presence of hyperacidity. Only one patient had partial pyloric stenosis preoperatively due to chronic duodenal ulcer. No drainage procedure was used after BTV, and an endoscopic pyloric balloon dilatation (PBD) was performed at the same time as vagotomy for 20 cases; 12 patients were followed without dilatation as a prospective trial. Semiliquid diet and promotility medication were started 24 h after surgery. All patients tolerated pure truncal vagotomy without any problem, except for two patients: one in whom open drainage procedure was required and one in whom PBD was performed. Basal acid output and peak acid output were measured the day before and 1 week after the operation. A mean decrease of hyperacidity was found: 70.6% for basal and 79.5% for peak acid output. Four patients suffered from moderate symptoms of diarrhea occurring intermittently and responded to medical treatment or recovered spontaneou...Continue Reading

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