Thoracoscopic vagotomy for recurrent ulcer after previous gastric operation

Aust N Z J Surg. 1997 Apr;67(4):177-80. doi: 10.1111/j.1445-2197.1997.tb01935.x.

Abstract

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.

MeSH terms

  • Adult
  • Endoscopy*
  • Gastrectomy*
  • Gastric Acid / metabolism
  • Helicobacter Infections
  • Helicobacter pylori
  • Humans
  • Male
  • Middle Aged
  • Peptic Ulcer Hemorrhage / etiology
  • Peptic Ulcer Hemorrhage / microbiology
  • Peptic Ulcer Hemorrhage / surgery*
  • Postoperative Complications / surgery*
  • Recurrence
  • Reoperation
  • Thoracoscopy
  • Vagotomy, Truncal / methods*