Loading…

The Aarhus County vagotomy trial. I. An interim report on primary results and incidence of sequelae following parietal cell vagotomy and selective gastric vagotomy in 748 patients

Since June, 1972 a total of 830 patients have been consecutively operated on electively for proven duodenal, pyloric, or prepyloric ulcer. For various reasons 82 patients were excluded, while 748 were allocated at random to parietal cell vagotomy (PCV) or selective gastric vagotomy (SGV). A drainage...

Full description

Saved in:
Bibliographic Details
Published in:World journal of surgery 1978-01, Vol.2 (1), p.85-90
Main Authors: Amdrup, E, Andersen, D, Høstrup, H
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Since June, 1972 a total of 830 patients have been consecutively operated on electively for proven duodenal, pyloric, or prepyloric ulcer. For various reasons 82 patients were excluded, while 748 were allocated at random to parietal cell vagotomy (PCV) or selective gastric vagotomy (SGV). A drainage (D) was added to PCV in 68 patients with gastric retention. In the SGV group, a secondary randomization between antrectomy (A) and drainage was performed when the peak acid output response to pentagastrin was 45 mEq/h or more. The patient material comprised 353 SGV + D, 54 SGV + A, 273 PCV, and 68 PCV + D. Five patients died postoperatively from cardiovascular disease (0.7%). Splenectomy was necessary in 4%, and 5 patients sustained an operative perforation of the esophagus or the cardia which was recognized at operation and successfully treated. Postoperative complications were evenly distributed, but were milder after PCV. Only 11% of patients with PCV were discharged from the hospital later than the 10th postoperative day, compared to 19% of patients after SGV + D. No patients had postoperative gastric retention after PCV, while 20 patients had retention after SGV + D, and in the following years vomiting was less frequent after PCV than after the other operations. A transitory dysphagia occurred in 9% of all patients and subsided in a couple of months. Dumping occurred significantly less frequently after PCV without D than after the other operations and was considerably milder. The addition of D to either PCV or SGV led to a similar incidence of dumping. It is concluded that it is unnecessary to add a drainage procedure to PCV and that PCV without D is followed by milder postoperative complications and a lower rate of sequelae than other operations for duodenal ulcer . Depuis juin 1972, 830 malades ont été opérés pour ulcère duodénal, pylorique ou pré‐pylorique. Quatrevingt‐deux malades ont été exclus de l'étude, pour des raisons diverses. Chez les 748 autres patients, une vagotomie, sélective (SGV) ou super‐sélective (PCV), a été faite, le choix étant fait par tirage au sort. Chez 68 malades présentant une stase gastrique, un drainage gastrique (D) a complété la PCV. Dans le groupe SGV, les patients ayant un débit acide maximal égal ou supérieur à 45 mEq/h en réponse à la pentagastrine ont eu, soit une antrectomie (A), soit un drainage gastrique, le choix étant également soumis au tirage au sort. Au total, il y a 353 SGV + D, 54 SGV + A, 273 PCV et 68 PCV +
ISSN:0364-2313
1432-2323
DOI:10.1007/BF01574469