PubMed · 51983
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W Sircus. 1975-08-02. Letter: Hypersecretion and length of history in duodenal ulceration.. https://doi.org/10.1016/s0140-6736(75)90697-2
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899 cases of slective promimal vagotomy were operated between 1974-1978 in the Surgical University Hospital Erlangen. The underlying disease was in all cases a chronical duodenal ulcer. The primary operative mortality was 0,6%. Intraopeatively measurements to control the sufficiency of the vagotomy Burge and Grassi proved to be necessary. We could verify by endoscopy a recurrence rate of 5,8-16,5% in the 1.-4. postoperative year. Only 58% of the recurrences could be found by x-ray investigations. 75-82% of the patients had a clinically perfect and good result. In patients with a proven recurrent ulcer there was nevertheless a good clinical result in 64%. Clinical results and complaints of the patients are therefore not sufficient as follow-up after selective proximal vagotomy and early detection of a recurrent ulcer. We believe, that one endoscopy per year is necessary.
After 138 selective proximal vagotomies--130 of which were performed because of chronic duodenal ulcer--the rate of the postoperative complications was 3,8%, which is very low; the primary lethality was 0,76%. At re-examination 68% of the patients were without complaints; 8% had a recurrent ulcer. Epigastric fulness (6%), dumping (1%) and diarrhea (1%) were rare. Because of our results we believe, that selective proximal vagotomy is the optimal method for the surgical treatment of duodenal ulcer.
The working classification of the ulcerous disease after Melikova is suitable for the differentiated demonstration of the gastric and duodenal ulcers. In connection with this principle of subdivision essential features of the disease, such as localisation of the ulcer, clinical course, morphological characteristics of the ulcer and the ulcer-carrying organ, gastro-intestinal functional parameters and complications of the ulcer are demonstrated.