[Treatment of recurrent ulcers after parietal cell vagotomy. Analysis of 18 cases].
One hundred and twenty seven patients had a follow-up of more than 4 years after parietal cell vagotomy for duodenal, pyloric or prepyloric ulcer. The recurrence rate is 15.8% (20 on 127). Eighteen patients who have recurred, had a follow-up of 2 years or more after treatment of the recurrent disease. Ten patients had a early recurrence (within 2 years); eight had a late one (more than 2 years). One patient had been operated as an emergency for perforation. Seventeen patients had first received a medical treatment. This treatment was sufficient for 10 out of 17. Seven patients were reoperated (3 partial gastrectomy), 4 partial gastrotomy associated with truncal vagotomy. Seven out of the 10 early recurrences was reoperated and only one of the 8 late recurrences was reoperated. The early recurrences seem to be more serious that the late ones. Medical treatment is always prescribed as first line therapy and a partial gastrectomy alone or with vagotomy is necessary in unsuccessful cases.
Service de Chirurgie Digestive, Hôpital Nord, Marseille.
J
J
Touchet
P
P
Orsoni
A
A
Caamano
R
R
Picaud
D000328:Adult; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000601:surgery*; D005500:Follow-Up Studies; D005743:Gastrectomy; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D011377:Proglumide / Q000627:therapeutic use; D012008:Recurrence; D012086:Reoperation; D013276:Stomach Ulcer / Q000188:drug therapy / Q000601:surgery*; D014629:Vagotomy, Proximal Gastric / Q000379:methods*; D015167:Vagotomy, Truncal
D006634:Histamine H1 Antagonists; D011377:Proglumide
Traitement des récidives ulcéreuses après vagotomie fundique. Analyse de dix-huit observations.