[Therapy of ulcer recurrence after vagotomy of oxyntic cells with sucralfate]

Several methods of treatment have been proposed for the recurrences of peptic ulcers after surgery; they consist of different forms of re-operation, medical treatment (H2 receptors antagonists, cytoprotectors, etc...). First, it is convenient to establish the cause of the recurrence and to rule out the presence of hypersecretory conditions, as inadequate previous surgery or a non identified gastrinoma. Because of the enhancing effect of the cytoprotective drugs on the defense mechanisms of the mucosal barrier, the group of patients with limited acid secretion and recurrent ulcer may obtain benefit from these drugs. To demonstrate this hypothesis we realized a prospective study on 30 patients with recurrent gastro-duodenal peptic ulcer after parietal cell vagotomy without drainage; all the patients were treated with sucralfate during two months. The results can be considered favourable, with endoscopic healing of the ulcer in more than 50% of the cases at the end of the treatment.