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Biomedical subjects

R J Clarke

Publications and source records attributed to R J Clarke.

At least 109 records · Page 6Linked to original sources
PubMed1973

The effect of preserving antral innervation and of a pyloroplasty on gastric emptying after vagotomy in man.

A prospective randomized trial of 40 duodenal ulcer patients is reviewed. The patients had one of four operations (selective vagotomy, proximal gastric vagotomy, selective vagotomy plus pyloroplasty, or proximal gastric vagotomy plus pyloroplasty). The gastric emptying of a hypertonic fluid meal was assessed before and three to four months after operation. Selective vagotomy without a drainage procedure results in gastric retention and should no longer be considered as a method of treatment for duodenal ulcer. Proximal gastric vagotomy without a drainage procedure does not lead to gastric retention. Initial gastric emptying is more rapid after proximal gastric vagotomy but the final emptying time is the same as before operation and this operation alters the pattern of gastric emptying less than the other operations. Pyloroplasty added to either selective or proximal gastric vagotomy results in loss of the normal regulation of gastric emptying, very rapid initial gastric emptying, and a significant increase in the incidence of ;dumping'. It appears from these studies that ;dumping' is due to rapid gastric emptying and mainly due to the drainage procedure.

Coloring Agents↗
PubMed1972

Vagotomy and pyloroplasty for gastric ulcer.

In a series of 68 patients with gastric ulcer who were treated by vagotomy and pyloroplasty there were no operative deaths, though one patient who received massive transfusions died 14 weeks later from hepatic necrosis probably associated with serum hepatitis. Four patients developed recurrent peptic ulceration requiring further surgical treatment. The clinical condition of all but three of the remainder was satisfactory after an average follow-up period of three years and two months. Of the 14 patients who presented with an acutely bleeding gastric ulcer, one subsequently required gastrectomy for continued bleeding; in all the others the immediate and long-term results were satisfactory. Of 21 patients with a "high" ulcer and 29 with combined gastric and duodenal ulceration one (4.8%) and three (10%) respectively suffered recurrences. We conclude that vagotomy and pyloroplasty is a satisfactory form of treatment for a high or bleeding gastric ulcer, but that for all other gastric ulcers some form of gastric resection is preferable.

Adult↗
PubMed1972

Gastric stasis and gastric ulcer after selective vagotomy without a drainage procedure.

Two independent trials of selective vagotomy without the addition of a drainage procedure in the treatment of uncomplicated duodenal ulcer have shown that gastric stasis may occur after the operation and that in some cases this may be complicated by gastric ulcer. These findings do not support the contention that selective vagotomy alone allows normal gastric emptying.

Adult↗
PubMed1972

The effect of retaining antral innervation on the reductions of gastric acid and pepsin secretion after vagotomy.

The result of a prospective trial of 40 patients with duodenal ulcer treated either by proximal gastric vagotomy (antrum innervated) or by selective vagotomy (antrum denervated) shows that they are equally effective in reducing gastric acid and pepsin secretion. Preservation of antral innervation by proximal gastric vagotomy reduces gastric secretion as effectively as denervation of the entire stomach.

Duodenal Ulcer↗