THE FOLLOW UP STUDY OF THE SURGICAL TREATMENT FOR DUODENAL ULCER:Gastric Secretion and Postsurgical Syndrome

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We have performed various surgical procedures on 121 duodenal ulcer patients including 20 cases with co-existing gastric ulcer in the last six years. The methods of operation were as follows; 2/3 gastrectomy were performed on 29 cases, selective vagotomy with drainage in 57 cases, selective proximal vagotomy with or without drainage in 27 cases, selective vagotomy and antrectomy in 6 cases and simple closure of perforated ulcer in 2 cases. Vagotomy was the main surgical procedures on patients with duodenal ulcer. The types of vagotomy adopted were determined by our criteria settled in 1974 by the preoperative assessment of acid and gastrin secretory responses to tetragastrin and meat extract stimulation. The 2/3 gastrectomy was preferred in patients with gastro-duodenal ulcer.Operative death was seen in two emergency cases, one with preoperative renal failure and the other with adrenal insufficiency. Three cases were reoperated, one for gastric ulceration which occurred at three years after SPV to duodenal ulcer, one for postoperative bleeding from residual duodenal ulcer after SV+P.P. and one for many gastric symptom after SV+P.P. following no abnormal finding at operation. The postoperative complaints were less frequent and the recovery to work was sooner in vagotomized group than gastrectomized group. SPV with or without drainage obtained the best clinical scores. Acid reduction rate in SPV was the lowest and the gastrin response was the highest compared with the other procedures, though in the postoperative output there was no Dbvious difference among all procedures. Basal acid output was 0.6-2.3 mEg/hr, maximal acid output was 6.0-7.5 mEg/hr.In general, our surgical results were considered to be satisfactory and our criteria for the selection of a surgical procedure to be reasonable.
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THE FOLLOW UP STUDY OF THE SURGICAL TREATMENT FOR DUODENAL ULCER:Gastric Secretion and Postsurgical Syndrome

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