Document Detail

Should cholecystectomy be combined with vagotomy and pyloroplasty?
MedLine Citation:
PMID:  75335     Owner:  NLM     Status:  MEDLINE    
Duodenal ulcers and gallstones, two of the commonest surgical conditions, affect respectively 10% of men and up to 20% of the population. Although many detailed studies of the treatment of these conditions have been conducted, there is no report of the results of surgery when the conditions coexist. 60 patients who had undergone vagotomy, pyloroplasty, and cholecystectomy were compared with age and sex matched controls who had undergone vagotomy and pyloroplasty alone or cholecystectomy alone. In the early postoperative period after the combined procedure there was a very high incidence of post-vagotomy diarrhoea (48.3%, P equal to 0.00013) and bile-reflux gastritis. The findings implicate bile-acids--their excretion and handling by the small intestine--in the aetiology of post-vagotomy diarrhoea. Where the conditions coexist truncal vagotomy and pyloroplasty should be avoided in the treatment of the duodenal ulcer because of the risk of post-vagotomy diarrhoea and bile-reflux gastritis.
T V Taylor; M E Lambert; S Qureshi; B Torrance
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Lancet     Volume:  1     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1978 Feb 
Date Detail:
Created Date:  1978-04-26     Completed Date:  1978-04-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  295-8     Citation Subset:  AIM; IM    
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MeSH Terms
Bile Acids and Salts / secretion
Cholelithiasis / surgery*
Diarrhea / etiology
Duodenal Ulcer / surgery*
Evaluation Studies as Topic
Gastrectomy / adverse effects*
Gastritis / etiology
Middle Aged
Postoperative Complications / prevention & control
Pylorus / surgery*
Vagotomy / adverse effects*
Reg. No./Substance:
0/Bile Acids and Salts

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

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