Combined antrectomy and Rouxen-Y anastomosis in the surgical treatment of recurrent peptic ulceration

Author:

Cooper G1,Bell G2

Affiliation:

1. Gartnavel General Hospital, Great Western Road, Glasgow

2. Department of Surgery, Inverclyde Royal Hospital, Larkfield Road, Greenock, PA16 0XN

Abstract

Abstract The results of antrectomy performed for recurrent peptic ulceration after vagotomy and drainage are frequently marred by bilious vomiting. Consequently, there has been interest in combining antrectomy with Roux-en-Y drainage to prevent this complication. The experience of one surgeon in revisional gastric surgery has been studied retrospectively. Thirty-six patients have been reviewed in detail, 24 of whom had a combined antrectomy and Roux-en-Y anastomosis: 16 for recurrent peptic ulceration, 2 for non-ulcer dyspepsia and 6 for bile reflux gastritis. None of these has required reoperation, and 12 of the 16 with recurrent ulcers have had a good result. Four of 12 who underwent antrectomy alone subsequently required biliary diversion. Combining antrectomy with a Roux-en-Y anastomosis prevents postoperative bile reflux gastritis and thereby the need for further revision on this account. The results of this approach compare well with those of other procedures used in the treatment of recurrent peptic ulceration.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference44 articles.

1. Critical appraisal of vagotomy and pyloroplasty;McDonald;Arch. Surg.,1970

2. Status of duodenal ulcer patients ten years or more after vagotomy-pyloroplasty;Stempien;Gastroenterology,1970

3. Five year follow-up results of operations for duodenal ulcer;Postlethwait;Surg. Gynecol. Obstet.,1973

4. Five to eight year results of truncal vagotomy and pyloroplasty for duodenal ulcer;Goligher;Br. Med. J.,1972

5. Prospective randomized multicentre trial of proximal gastric vagotomy or truncal vagotomy and antrectomy for chronic duodenal ulcer: interim results;Dorricot;Br. J. Surg.,1978

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