scholarly journals Highly selective vagotomy and gastrojejunostomy in the treatment of peptic ulcer induced gastric outlet obstruction

2014 ◽  
Vol 71 (11) ◽  
pp. 1013-1017 ◽  
Author(s):  
Nebojsa Radovanovic ◽  
Aleksandar Simic ◽  
Ognjan Skrobic ◽  
Milutin Kotarac ◽  
Nenad Ivanovic
Keyword(s):  
Peptic Ulcer ◽  
Gastric Outlet Obstruction ◽  
Intraoperative Complications ◽  
Outlet Obstruction ◽  
Upper Gastrointestinal Endoscopy ◽  
Ulcer Recurrence ◽  
Selective Vagotomy ◽  
Highly Selective Vagotomy ◽  
Retrospective Clinical Study

Background/Aim. The incidence of peptic ulcer-induced gastric outlet obstruction is constantly declining. The aim of this study was to present our results in the treatment of gastric outlet obstruction with highly selective vagotomy and gastrojejunostomy. Methods. This retrospective clinical study included 13 patients with peptic ulcer - induced gastric outlet obstruction operated with higly selective vagotomy and gastrojejunostomy. A 3-year follow-up was conducted including clinical interview and upper gastrointestinal endoscopy on 1 and 3 years after the surgery. Results. The most common preoperative symptom was vomiting (in 92.3% of patients). The mean preoperative body mass index was 16.3 ? 3.1 kg/m2, with 9 patients classified preoperatively as underweight. There were no intraoperative complications, nor mortality. At a 3-year follow-up there was no ulcer recurrence. Delayed gastric emptying was present in 1, bile reflux in 2, and erosive gastritis in 1 patient. Two patients suffered from mild ?dumping? syndrome. Conclusion. Higly selective vagotomy combined with gastrojejunostomy is a safe and easily feasible surgical solution of gastric outlet obstruction induced by peptic ulcer. Good functional results and low rate of complications can be expected at a long-term follow-up.

Duodenal Ulcer Treated by Highly Selective Vagotomy

1986 ◽  
Vol 16 (4) ◽  
pp. 160-163 ◽  
Author(s):  
A O Arigbabu ◽  
C O Omole ◽  
D O Akinola
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Clinical Results ◽  
High Rate ◽  
Truncal Vagotomy ◽  
Cure Rate ◽  
Selective Vagotomy ◽  
Highly Selective Vagotomy

Over a period of 5 years 102 highly selective vagotomies (HSV) were performed. The cases selected excluded gastric outlet obstruction. The results show a significant cure rate of peptic ulcer, without any deaths. It is suggested that the high rate of recurrences and complications reported from other centres might be due to incomplete denervation, most likely due to variations of the nerve or damage to the nerve of Latarjet, amounting to truncal vagotomy — Complete or incomplete, depending on the nature and level of damage to the nerve. From our experience at this centre, HSV has given very good clinical results in the 5 years of review. The procedure is safe and without mortality.

Temporal Trends of Peptic Ulcer Disease in Kashmir, India

JMS SKIMS ◽  
2012 ◽  
Vol 15 (2) ◽  
pp. 136-140
Author(s):  
G M Gulzar ◽  
Showkat A Zargar ◽  
Muzaffar Nazir ◽  
Gul Javid ◽  
Bashir A Khan ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Gastric Outlet Obstruction ◽  
Temporal Trends ◽  
Outlet Obstruction ◽  
Life Time ◽  
Point Prevalence ◽  
Asymptomatic Group ◽  
Ulcer Disease ◽  
Ulcer Perforation

BACKGROUND: Since late 1960s, the prevalence of peptic ulcer disease and its complications has been steadily decreasing. OBJECTIVE: To ascertain the changing trends in the prevalence and complications of peptic ulcer in Kashmir. METHODS: A cohort of 10474 people aged 15-60 years in district Baramulla of Kashmir was interviewed about symptoms, complications, and surgery related to peptic ulcer. People were enquired about smoking, use of NSAIDs, H2 Receptor antagonists, proton pump inhibitors and endoscopies. All symptomatic and randomly selected group of asymptomatic people underwent esophago-gastro-cluodenoscopy. RESULTS: In symptomatic group, 286 (41.45%) people hod peptic ulcer and in asymptomatic group 24 (5.35%) had peptic ulcer. There were 71 already diagnosed cases of peptic ulcer; totaling 381. Thirty three people had surgery for peptic ulcer. The point prevalence of peptic ulcer was 3.54% and lifetime prevalence 8.96%. The highest prevalence was in 4th decade. Bleeding was seen in 23.63%, gastric outlet obstruction 4.20%, ulcer perforation 0.52%. 9.39% of peptic ulcer patients had undergone surgery. When compared to previous study in 1985 in Kashmir, there was decrease in point prevalence of 25%, in life-time prevalence of 20.14%, Gastric outlet obstruction by 51.7%, ulcer perforation by 87%, surgery rate by 60% and bleeding by a marginal 2%. CONCLUSION: Prevalence of peptic ulcerand its complications (except bleeding) are showing downward trend in Kashmir over the last 20 years. JMS 2012;15(2):136-40

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

scholarly journals TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

2020 ◽  
pp. 28-31
Author(s):  
HASSAN KHUDER RAJAB ◽  
ALI ESMAIL AL-SNAFI
Keyword(s):  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Endoscopic Examination ◽  
Urea Breath Test ◽  
Ulcer Recurrence ◽  
Follow Up Study ◽  
History Of ◽  
Second Year ◽  
H Pylori

Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.

Early return to work following highly selective vagotomy

1990 ◽  
Vol 76 (1) ◽  
pp. 39-42
Author(s):  
D. N. Tulloch ◽  
E. P. Dewar
Keyword(s):  
Duodenal Ulcer ◽  
Ulcer Recurrence ◽  
Royal Navy ◽  
Selective Vagotomy ◽  
Highly Selective Vagotomy ◽  
Early Return ◽  
The Mean ◽  
A Prospective Study ◽  
Return To Duty ◽  
Mean Time

SummaryIn the Royal Navy, after surgery, the time that servicemen spend away from work and the level of duty to whch they return are decisions made by the surgeon, not the general practitioner.In a prospective study, we have thus been able to assess the acceptability of return to full duty at decreasing intervals after highly selected vagotomy (HSY).Seventy-eight service men who underwent HSY for duodenal ulcer were studied in three periods, 1978–1980, 1981–1982, 1983–1986, each with a shorter interval to return to duty.There were no differences in the rates of ulcer recurrence, incisional hernia, or ability to perform full duties.After HSY the mean time to return to full duties for each group was 29.3, 16.4, and 4.2 weeks, respectively. Every patient returned to full duties at 28 days was able to perform any assigned task whether at sea or ashore.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

scholarly journals Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

2020 ◽  
Vol 08 (09) ◽  
pp. E1194-E1201 ◽  
Author(s):  
Janine B. Kastelijn ◽  
Leon M.G. Moons ◽  
Francisco J. Garcia-Alonso ◽  
Manuel Pérez-Miranda ◽  
Viliam Masaryk ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Endoscopic Ultrasound ◽  
Palliative Treatment ◽  
Clinical Success ◽  
Outlet Obstruction ◽  
Invasive Technique ◽  
Technical Success ◽  
Ultrasound Guided ◽  
Malignant Gastric Outlet Obstruction

Abstract Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) with a lumen-apposing metal stent (LAMS) is a novel, minimally invasive technique in the palliative treatment of malignant gastric outlet obstruction (GOO). Several studies have demonstrated feasibility and safety of EUS-GE, but evidence on long-term durability is limited. The aim of this study was to evaluate patency of EUS-GE in treatment of malignant GOO. Patients and Methods An international multicenter study was performed in seven centers in four European countries. Patients who underwent EUS-GE with a LAMS between March 2015 and March 2019 for palliative treatment of symptomatic malignant GOO were included retrospectively. Our main outcome was recurrent obstruction due to LAMS dysfunction; other outcomes of interest were technical success, clinical success, adverse events (AEs), and survival. Results A total of 45 patients (mean age 69.9 ± 12.3 years and 48.9 % male) were included. Median duration of follow-up was 59 days (interquartile range [IQR] 41–128). Recurrent obstruction occurred in two patients (6.1 %), after 33 and 283 days of follow-up. Technical success was achieved in 39 patients (86.7 %). Clinical success was achieved in 33 patients (73.3 %). AEs occurred in 12 patients (26.7 %), of which five were fatal. Median overall survival was 57 days (IQR 32–114). Conclusions EUS-GE showed a low rate of recurrent obstruction. The relatively high number of fatal AEs underscores the importance of careful implementation of EUS-GE in clinical practice.

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