Background/Aims:
@EN We planed the study to evaluate the ideal procedure in surgical aspect of peptic ulcer through comparision of results in each procedure.
@ES Methods:
@EN we reviewed 147 patients treated during 1987 to 1993 at department of surgery, Soonchunhyang University Hospital.
@ES Results:
@EN The indications of operation were perforation (63.3%), obstruction (17.7%), bleeding (15.0%), intractability (2.0%) and others (2.0%) in order of frequency. Truncal vagotomy and pyloroplasty was performed in 70 patients (47.6%), truncal
vagotomy and
antrectomy in 27 patients (17.4%), subtotal gastrectomy in 19 patients (12.9%), truncal vagotomy and gastrojejunostomy in 15 patients (10.2%), primary closure in 10 patients (6.8%) and other procedures in 6 patients (4.1%). Perioperative
mortality
rate
was 1.4 % (2 patients) that these patients have severe and uncontrolled medical illness. Among 147 cases, follow-up evaluation was possible in 83 cases. The 66 cases (79.6%) was classified excellent and very good group according to Goligher's
modified
Visick classification. In this study, ulcer recurrence rate was as follows: truncal vagotomy and antrectomy 0%, truncal vagotomy and pyloroplasty 7.9%, subtotal gastrectomy 9.1%, truncal vagotomy and gastrojejunostomy 22.2%, and primary closure
60.0%.
Reoperation was necessary in 4 cases after antrectomy and truncal vagotomy (14.8%), 1 patient after truncal vagotomy and pyloroplasty (1.5%) and 2 cases after truncal vagotomy and gastrojejunostomy (13.3%).
@ES Conclusions:
@EN Considering postoperative complication and reoperation rate, we conclude that truncal vagotomy and pyloroplasty was more acceptable and safe procedure than truncal vagotomy and antrectomy in perforated peptic ulcer, even though its relatively
higher
recurrence rate. (Korean J Gastroenterol 1995; 27: 626-634)
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