| Effect of the pre-operative response to H2 receptor antagonists on the outcome of highly selective vagotomy for duodenal ulcer. | |
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MedLine Citation:
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PMID: 2889503 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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From 1979 to 1984, 141 consecutive patients (110 men, 31 women) underwent highly selective vagotomy (HSV) for duodenal ulcer (DU). All patients had received pre-operative treatment with full dose H2 receptor antagonists (H2RA). Indications for surgery were: persistent relapse on withdrawal of H2RA, 107 (75.9 per cent); no response to H2RA, 30 (21.3 per cent); intolerance of H2RA, 1 (0.7 per cent); acute DU bleed, 2 (1.4 per cent); duodenal stenosis, 1 (0.7 per cent). Follow-up with a median of 47 months (24-85 months) revealed six patients (4.4 per cent) with endoscopically proven recurrence, three of whom were on non-steroidal anti-inflammatory drugs (NSAIDs). Only one patient with recurrent DU was a non-responder to H2RA pre-operatively. Twenty-five patients remained symptomatic after HSV without ulcer recurrence, of which a highly significant proportion (41 per cent) were non-responders (P less than 0.001). The pre-operative response to H2RA does not indicate the likelihood of ulcer recurrence after HSV. However, non-responders are more likely to continue with dyspeptic symptoms despite the successful healing of their ulcers. The DU recurrence rate in patients taking long-term NSAIDs is disappointingly high (33 per cent), putting the use of HSV in these patients into question. |
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Authors:
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A J Goodman; D D Kerrigan; A G Johnson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The British journal of surgery Volume: 74 ISSN: 0007-1323 ISO Abbreviation: Br J Surg Publication Date: 1987 Oct |
Date Detail:
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Created Date: 1987-12-14 Completed Date: 1987-12-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 897-9 Citation Subset: AIM; IM |
Affiliation:
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University Surgical Unit, Royal Hallamshire Hospital, Sheffield, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Duodenal Ulcer / drug therapy, surgery* Female Histamine H2 Antagonists / therapeutic use* Humans Male Middle Aged Preoperative Care Recurrence Vagotomy, Proximal Gastric* |
| Chemical | |
Reg. No./Substance:
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0/Histamine H2 Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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