Pyloric channel ulcers: management and three-year follow-up

Twenty-five patients with pyloric channel ulcers are presented. They were predominantly males (84%), with a mean age of 54 years. Four patients were operated upon in the initial admission because of gastric outlet obstruction in three and persistent bleeding in one. Twenty-one patients received H2-antagonist treatment (ranitidine 150 mg or cimetidine 400 mg twice a day). Clinical and endoscopic healing rates were 76% and 38% respectively at 6 weeks, and 91% and 85% respectively at 12 weeks of treatment. The recurrence rate at an average of 3 years of follow-up period on maintenance treatment (ranitidine 150 mg or cimetidine 400 mg nightly) was 65%. Three patients were operated upon during the follow-up period due to persistent symptoms in two and recurrence with obstruction in one Surgical procedures were vagotomy + drainage (five patients) and vagotomy + antrectomy (two patients). There were no recurrences in surgically treated patients at an average of 3.5 years of follow-up, and all were graded as Visick I or II.