The clinical study on 326 cases of gastric surgery cases admitted to Department of General Surgey of Seoul Adventist Hospital from Jan. 1976 to Dec. 1981 was done.
The results were as follow:
1) In 326 cases 81 cases were gastric ulcer, 98 cases were duodenal ulcer, 8 cases were combined gastric and duodenal ulcer, 22 cases were erosive gastritis, 117 cases were stomach cancer.
2) The percetage ratio of gastric surgery cases to the total number of admitted cases (6706 cases) in the Department of Surgery during the above mentioned. period was 11. 62%.
3) The peak age incidence in gastric ulcer was 41?60 age group of 58.0%,. 21?40 age group of 71.5% in duodenal ulcer, 21~30 age group in erosive gastritis, 41?60 age group of 70.1% in stomach cancer.
4) The ratio of male to female was dominantly high in male: 4.1:1 in gastric ulcer, 7.9:1 in duodenal ulcer, 3:1 in combined gastric and duodenal uker, 10:1 in erosive- gastritis, 2.3:1 in stomach cancer.
5) The main subjective symptoms in order of frequency were as follow: epigastric pain and discomfort, indigestion, anorexia, nausea and vomiting in peptic ulcer disease, and epigastric pain and discomfort, nausea and vomiting, epigastric fullness in erosive gastritis, and epiga- .-stric pain and discomfort, epigastric fullness, indigestion, anorexia, general weakness in stomach cancer.
6) The main objective signs in order of frequency were as follow: epigastric tenderness, weight loss, tarry stool in peptic ulcer, and anemia, epigastric tenderness in erosive gastritis, and palpable mass, weight loss, epigastric tenderness, anemia in stomach cancer.
7) The most frequent siteS of lesion were as follow: pyiorus in gastric ulcer, duodenal bulb in duodenal ulcer, pylorus in stomach cancer.
8) Operative procedures were as follow: subtotal gastrectomy with B-Ⅱ anastomosis (72.8%), vagotomy with antrectomy (22.2%) in gastric ulcer, and vagotomy with pyloroplasty(45.9), vagotomy with antrectomy(29.6%), subtotal gastrectomy with B-Ⅱ anastomosis(22.4%), simple closure(2%) in duodenal ulcer, and subtotal astrectomy with B-Ⅱ anastomosis(100%) in combined gastric and duodenal ulcer, and vagotomy with antrectomy (50%), vagotomy with pyloroplasty(22.7%), subtotal gastrectomy with B-Ⅱanastomosis(18.2%), total gastrectorny(9.1%) in erosive gastritis. and radical subtotal gastrectomy with B? fi anastomosis(78.6%). total gastrectomy(16.2%), gastroenterostomy only(5.1%) in stomach cancer.
9) The early postoperative complications were observed in 105 cases(32.2%), that in order of frequency was wound infection (12.3%), atelectasis(4.3%), pneumonia (3.7%), duodenal stump leakage(3. 1%), anastomotic leakage(2.5%), intraluminal hemorrhage(l.8%), acute pancreatitis(l. 8%), thrombophlebitis(1.5%), subphrenic abscess(1.2%). Complications according to operative procedures were as follows in order of frequency: simple closure(75%), vagotomy with pyloroplasty(46%), radical subtotal gastrectomy with B?fl anastomosis(34.0%), gastroenterostomy(33.3%), subtotal gastrectomy with B?J[ anastomosis(31.2%), total gastrectomy(23.8%), vagotomy with antrectomy(19.0%).
10) The percentage of late postoperative complications were as follows: dumping syrdrome (12.9%), weight loss(41.4%), diarrhea(10.1%), anemia(37. 1%).
11) Operative mortality was 2.4%.
|