Many kinds of surgical methods were introduced in the treatment of peptic duodenal cancer. The
purpose of this study is to present follow up results of 92 cases pf peptic duodenal cancer, (which
were) treated by trans-abdominal trunkal vagotomy with drainage procedure at National Medical
Center, from Jan. 1966, to Dec. 1969.
1) Distribution of age was most provalent in 3rd decade to 4th decade, (58% of all 92 cases)
and male to female was 3.6 to 1.
2) The duration of disease is more than 5 years, in 43% (40% cases of all 92 cases).
3) In all 92 cases operated, intractable pain is most frequet (42 cases of all 92 cases), pyliric
stenosis to 15 cases and next, perforation to 13 cases.
In the perforation cases of duodenal cancer, 13% (12 cases of all 92 cases) received emergent
vagotomy and drainage procedure.
4) Duration of disease was more than 3 years in the majority of intractable pain & pyloric
stenosis, while within 3 years in the cases of bleeding & perforated cases.
5) Surgical methods was intra-abdominal, bilateral trunkal vagotomy with drainage procedure,
which was Heinecke-Mikulicz in 35 cases, Finnyey pyloroplasty in 31 cases, gastro-jejunostomy in
26 cases.
6) The most frequent early complication of surgery was wound infection. ( 4 cases of all 92
cases).
7) The reduction rate of Manimal acidity by augmented histamin test revealed average 68.7%
in pyloroplasty group and 63.9% in gastro-jejunostomy group.
8) Postoperative diarrhea in the associater with trunkal vagotomy was 51.5% (34 cases of all
66 cases) in pyloroplasty and 46.1% in gastro-jejunostomy. (12 cases of all 26 cases).
However 70% of diarhea group was unsignificant and severe type of diarrhea was not found.
9) Recurrent cases were 3, which were 1 case in the pyloroplasty and 2 cases in the gastrojej
unostomy.
These 3 cases were positive in Hollander test, resulted by incomplete vagotomy. 2 cases of these
3 cases received emergent operation.
10) Excellent and good group in over all result was 88%, Fair group is 7.6% and failure group
is 4.4% in pyloroplasty, while excellent and good group is 84.6%, fair to 7.7% and failure to
7.7% in gastrojejunostomy group.
11) Trunkal vagotomy with drainage procedure seems the most reliable method in the surgical
treatment of the chronic duodenal ulcer, un an accordance with the least morbidity and mortality.
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