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The changing pattern in peptic ulcer surgery.

T Suchý, K Kabelác, B Jon

    Sbornik Vedeckych Praci Lekarske Fakulty Karlovy University V Hradci Kralove
    |January 1, 1992
    PubMed
    Summary
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    Surgical treatment for peptic ulcer disease (PUD) declined, shifting towards less invasive procedures like proximal gastric vagotomy. This trend reflects a global move towards more physiological surgical methods for PUD management.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Clinical Medicine

    Background:

    • Peptic ulcer disease (PUD) management has evolved significantly.
    • Surgical interventions for PUD have seen changes in methodology and frequency.

    Purpose of the Study:

    • To analyze the shift in surgical treatment methods for peptic ulcer disease (PUD) over two distinct periods.
    • To compare the types of surgical procedures and their outcomes for PUD between 1979-1983 and 1985-1989.

    Main Methods:

    • Retrospective analysis of PUD surgical cases, excluding perforated ulcers.
    • Comparison of surgical approaches: classical partial gastrectomies versus proximal gastric vagotomy and vagotomy with antrectomy.
    • Evaluation of complication rates, ulcer type ratios, mortality, and morbidity.

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    Main Results:

    • A decrease in the total number of PUD operations from 206 to 94.
    • A significant shift from classical partial gastrectomies (94%) to proximal gastric vagotomy (40.4%) and vagotomy with antrectomy (26.6%).
    • Increased complicated PUD cases (43.2% to 53.2%), altered duodenal to gastric ulcer ratio (3:1 to 2:1), and stable low mortality/morbidity rates.

    Conclusions:

    • The study confirms a worldwide trend of reduced surgical intervention for PUD.
    • There is a clear shift towards less invasive, more physiological surgical procedures for PUD.
    • Proximal gastric vagotomy and its modifications are becoming preferred methods in PUD surgery.