Laparoscopic Treatment of Duodenal Ulcers: A vagotomy assessed by the congo red test.
- Author:
Sang Ho LEE
1
;
Gyu Seog CHOI
;
Wansik YU
Author Information
1. Department of Surgery, Kyungpook National University Hospital.
- Publication Type:Original Article
- Keywords:
Laparoscopic vagotomy;
Congored test;
Visik criteria
- MeSH:
Congo Red*;
Congo*;
Drainage;
Duodenal Ulcer*;
Duodenum;
Follow-Up Studies;
Gastrectomy;
Gastric Acid;
Gastric Mucosa;
Gastroparesis;
Humans;
Laparoscopy;
Length of Stay;
Peptic Ulcer;
Ulcer;
Vagotomy*;
Vagotomy, Proximal Gastric;
Vagotomy, Truncal
- From:Journal of the Korean Surgical Society
1999;56(2):225-232
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The aim of this study is to show the effectiveness and the safety of laparoscopic surgery for the treatment of complicated duodenal ulcers. METHODS: From September 1994 to July 1997, 30 hemodynamically stable patients underwent laparoscopic surgery for the treatment of complicated duodenal ulcers, including 13 free perforations, 12 obstructions and 5 intractabilities. Operations consisted of a truncal vagotomy with a drainage procedure, a proximal gastric vagotomy (posterior truncal vagotomy with anterior seromyotomy) and simple closure of the perforation in 16, 9, 5 cases, respectively. In the beginning of this study, congo-red tests were attempted in 12 patients, intraoperatively in 7 and postoperatively in 5, to assess the reliability of a laparoscopic vagotomy. Long-term follow up was evaluated using by modified Visik criteria. RESULTS: The mean operation time was 150 (80-230) minutes. Oral intake resumed on the third postoperative day. The mean hospital stay was 8.4 days. There was one intraoperative open conversion. In another case, a distal subtotal gastrectomy followed due to persistent postoperative gastric stasis. Six of 7 intraoperative congo red tests showed black-to-red discoloration of the gastric mucosa, which meant reduced gastric acidity. However, in the postoperative group, only 2 of 5 cases did. The mean follow-up period was 21 (3-38) months. There were 2 recurrent ulcers. One was on the duodenum; the other was a marginal ulcer. CONCLUSIONS: Laparoscopic surgery for the treatment of complicated duodenal ulcers is technically feasible, effective, and safe.
