[Gastroduodenal ulcer. New therapy and new clinical practice?].
Duodenal, prepyloric, and gastric ulcers are based on different pathophysiological processes. The achievements obtained from therapeutic medication, using H2-blockers, have reduced indications for surgical treatment, primarily for duodenal ulcer. Surgery has continued to be required for failure of medicamentous therapy, recurrence, development of intercurrent diseases calling for corticoid or anti-coagulant treatment, patients above 55 years of age with haemorrhage, occurrence of severe side effects, and, occasionally, for economic reasons. Optional methods are left-side selective vagotomy for duodenal ulcer, antrectomy with bilateral subdiaphragmatic vagotomy for prepyloric ulcer, and hemigastrectomy with gastroduodenal anastomosis for gastric ulcer.
Hollender
L F
LF
Service de Chirurgie Digestive et Generale I, Centre Hospitalo-Universitaire de Strasbourg-Hautepierre.
Bahnini
J
J
de Manzini
N
N
D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010437:Peptic Ulcer / Q000601:surgery*; D010438:Peptic Ulcer Hemorrhage / Q000601:surgery; D011706:Pyloric Antrum / Q000601:surgery; D012008:Recurrence; D014629:Vagotomy, Proximal Gastric / Q000379:methods; D015167:Vagotomy, Truncal / Q000379:methods
Das Gastroduodenalulkus. Neue Therapie und neue Praxis?