Document Detail


Effect of the pre-operative response to H2 receptor antagonists on the outcome of highly selective vagotomy for duodenal ulcer.
MedLine Citation:
PMID:  2889503     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A J Goodman; D D Kerrigan; A G Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  74     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1987 Oct 
Date Detail:
Created Date:  1987-12-14     Completed Date:  1987-12-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  897-9     Citation Subset:  AIM; IM    
Affiliation:
University Surgical Unit, Royal Hallamshire Hospital, Sheffield, UK.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Histamine H2 Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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