[The treatment of upper digestive hemorrhages due to duodenal ulcer by direct hemostasis and vagotomy of the oxyntic cells].
Management of upper gastrointestinal haemorrhage continues to present a challenge in surgical judgment. To evaluate the incidence of rebleeding, ulcer recurrence, mortality and morbidity derived from the surgical technique, we made a prospective study in patients with active bleeding duodenal ulcer (endoscopy diagnosis in all cases), excluding patients with serious intercurrent diseases NSAIDS intake drugs and over seventy years of age. In 49 patients, oxyntic cell vagotomy with undersewing bleeding ulcer were performed in the period 1972-1984. Periodic controls were established, included clinical, radiographic and gastroduodenoscopic evaluation. Five years after operation 35 patients could be evaluated. In these cases, mortality was nil. No early rebleeding was observed. Long term endoscopic results showed only 2.85% of relapses. The results obtained in this study show that oxyntic cell vagotomy with undersewing bleeding ulcer may be a technique of choice in the treatment of bleeding duodenal ulcers and it should be more extensively used in emergency services.
Docobo Durántez
F
F
Hospital Universitario Virgen del Rocío, Departamento de Cirugía, Sevilla.
Fernández Dovale
M
M
Lozano Crivell
M
M
Gómez Bravo
M A
MA
Del Alamo Juzgado
C
C
Jurado Marchena
R
R
Mena Robles
J
J
D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000502:physiology*; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D014628:Vagotomy / Q000379:methods*
Tratamiento de las hemorragias digestivas altas por úlcera duodenal mediante hemostasia directa y vagotomía de células oxínticas.