[The place of selective proximal vagotomy in complicated duodenal ulcers].
From 1980 to 1988 417 patients underwent surgery for peptic duodenal ulcer. Complications were present in 217 patients: perforation (40%), bleeding (32%), stenosis (20%) or penetration (8%). Highly selective vagotomy was performed in 67% of all patients. The number of operations for duodenal ulcer decreased (1984 n = 61, 1988 n = 28) due to fewer operations for uncomplicated ulcers, whereas the number of operations for complicated cases remained equal. Mortality after highly selective vagotomy for complicated duodenal ulcer was 5.2%. All fatalities occurred after bleeding. Whereas highly selective vagotomy was performed frequently for stenosing (72%) and bleeding (68%) ulcers it was the exception in perforate duodenal ulcers (13%). A tendency to increased performance of highly selective vagotomy in complicated cases is evident (1981 40%, 1988 70%). A further increase seems possible by using more liberal indications for selective vagotomy in perforated ulcers and by more frequently carrying out preoperative endoscopic hemostasis in bleeding duodenal ulcers.
Armbruster
C
C
I. Chirurgische Abteilung, Krankenanstalt Rudolfstiftung, Wien.
Dittrich
K
K
Kriwanek
S
S
D004380:Duodenal Obstruction / Q000601:surgery*; D004381:Duodenal Ulcer / Q000401:mortality / Q000601:surgery*; D006801:Humans; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D014629:Vagotomy, Proximal Gastric
Der Stellenwert der selektiv proximalen Vagotomie beim komplizierten Ulcus duodeni.