Laparoscopic truncal vagotomy and gastroenterostomy for pyloric stenosis.
BACKGROUND
Gastric outlet obstruction secondary to chronic duodenal ulceration is an indication for surgery as conservative management with balloon dilatation frequently fails. The standard operation is truncal vagotomy and a drainage procedure. However, development of minimally invasive surgery has revolutionized the surgical approach to this clinical problem.


METHODS
Twelve male patients with pyloric stenosis secondary to duodenal ulceration underwent laparoscopic truncal vagotomy and gastrojejunostomy. The perioperative and long term outcome of this group of patients were analyzed.


RESULTS
The median operating time was 210 (range 180 to 240) minutes. Median postoperative stay was 6 (range 4 to 41) days. Conversion to laparotomy was necessary in one patient. Delayed gastric emptying occurred in two patients but resolved on conservative measures. At a median postoperative followup of 6 (range 1 to 12) months all patients had a good symptomatic outcome (Visick grades I or II).


CONCLUSIONS
Laparoscopic truncal vagotomy and gastrojejunostomy is a feasible technique. Intermediate followup shows good symptomatic results when used for pyloric stenosis.
Wyman
A
A
Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong.
Stuart
R C
RC
Ng
E K
EK
Chung
S C
SC
Li
A K
AK
D000328:Adult; D004381:Duodenal Ulcer / Q000150:complications; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011707:Pyloric Stenosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014628:Vagotomy / Q000379:methods*