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Vagotomy and antrectomy revisited.

C Kotwall1, H T Williams

  • 1Department of Surgery, University of Alberta Hospital, Edmonton.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|October 1, 1990
PubMed
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Truncal vagotomy and antrectomy is a safe procedure for duodenal ulcer disease, showing low mortality and morbidity. This surgical approach remains effective despite advances in treatment, with a low rate of ulcer recurrence.

Area of Science:

  • Gastroenterology
  • Surgical Oncology

Background:

  • Duodenal ulcer disease management has evolved, with surgical interventions like vagotomy and antrectomy being historically significant.
  • Assessing the long-term outcomes of traditional surgical procedures is crucial for current clinical practice.

Purpose of the Study:

  • To evaluate the mortality, morbidity, and long-term efficacy of truncal vagotomy and antrectomy in treating duodenal ulcer disease.

Main Methods:

  • A retrospective review of 185 patients who underwent truncal vagotomy and antrectomy.
  • Analysis of early outcomes (mortality, morbidity) and long-term follow-up using Visick's classification and ulcer recurrence rates.

Main Results:

  • The study reported a low in-hospital mortality rate (0.54%) and early morbidity of 11.4%, with 3 patients needing reoperation.

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  • Long-term follow-up (average 13.5 years) in 83 patients showed 90.4% in Visick classes I or II, and only 2 cases of recurrent ulceration.

    • Conclusions:

    • Truncal vagotomy and antrectomy demonstrate a favorable safety profile and acceptable long-term results for duodenal ulcer disease.
    • The procedure's efficacy, particularly its low recurrence rate compared to some alternatives like highly selective vagotomy, suggests it should remain a viable option.