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Poon, Ronnie; Chow, Louis; Lim, Boon; Gertsch, Phillip
Australian and New Zealand Journal of Surgery, April 1997, Letnik: 67, Številka: 4Journal Article
Background: Recurrent peptic ulcer after previous gastric operation is a difficult surgical problem and abdominal re‐operation is associated with significant morbidity, mortality and recurrence rate. Methods: The authors report on five patients with recurrent ulcers who, after previous gastric operation, were treated with thoracoscopic vagotomy. Results: All patients tolerated the procedure well without complications, and the median hospital stay was 5 days. Endoscopy confirmed healing of the ulcers in all patients. Pre‐operative and postoperative gastric acid studies showed a significant postoperative reduction in both basal and maximal acid output (P < 0.05). In a follow‐up period of 18–33 months, one patient had a recurrent ulcer presenting with bleeding. Gastric biopsy revealed presence of Helicobacter pylori and repeated gastroscopy after a course of H. pylori eradication treatment showed a healed ulcer. The other four patients were asymptomatic. Conclusions: We conclude that thoracoscopic vagotomy is a simple and safe procedure for the treatment of recurrent ulcers after previous gastric operation, but the long‐term results need further assessment.
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