170 patients five years after selective gastric vagotomy--with an uncontrolled comparison of ulcer recurrence following either Heineke--Mikulicz or Finney pyloroplasty.
The study concerns 170 patients treated for duodenal ulcer by selective gastric vagotomy and either HM- or FP. A 5-year follow-up showed a 4% recurrence rate. Insulintest 2-3 months after surgery was Hollander negative in 78%, late positive in 17% and early positive in 5%. 72% of the tests were unchanged after 5 years. 25% had moderate severe dumping. In the HM-group of 84 patients, 6 patients displayed ulcer recurrence. In the F-group of 86 patients, one displayed recurrence. All patients with recurrence (and one without) in the HM-group had operatively demonstrated pyloroplasty stenosis. None of the patients in the F-group had clinical symptoms of gastric stasis. The only variable in the treatment of the patients was the pyloroplasty method, and it thus seems reasonable to implicate the pyloroplasty method in the incidence of recurrence. The difference in recurrence between the two groups was not, however, statistically significant, and the value of a prospective randomized study of patients treated by selective gastric vagotomy and different pyloroplasty forms is pointed out.
D004381:Duodenal Ulcer / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin; D008297:Male; D011178:Postgastrectomy Syndromes; D011707:Pyloric Stenosis / Q000209:etiology; D011708:Pylorus / Q000601:surgery*; D012008:Recurrence; D014628:Vagotomy / Q000379:methods
D007328:Insulin