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Is Vagotomy and Gastrectomy Still Justified for Gastroduodenal Ulcer?

 

作者: Charles Witte,  

 

期刊: Journal of Clinical Gastroenterology  (OVID Available online 1995)
卷期: Volume 20, issue 1  

页码: 2-3

 

ISSN:0192-0790

 

年代: 1995

 

出版商: OVID

 

关键词: Peptic ulcer;M. pylori;Vagotomy;Gastrectomy

 

数据来源: OVID

 

摘要:

Definitive treatment of peptic ulcer has traditionally focused on “acid control,” including such operations as partial gastrectomy and truncal vagotomy. Whereas these therapies have generally been successful, untoward side effects persist, especially after major operations. The recent discovery that Helicobacter pylori is the prime causative agent of the peptic diathesis and that its eradication from the stomach lining is associated with long-term remission of ulcer disease suggests that current surgical treatment protocols should now be modified accordingly. For treatment of life-threatening complications, such as bleeding, perforation, and obstruction, operation is still mandatory; however, the bleeding artery should simply be ligated, the perforation “plugged,” or the obstruction bypassed. For definitive management of the ulcer, short-term treatment with H2 and proton blockers should be promptly instituted. For long-term “cure,” H. pylori should be eliminated from the stomach by administration of appropriated antibiotic drugs. Vagotomy and partial gastrectomy and its myriad varaitions to prevent ulcer recurrence are no longer necessary nor appropriate

 

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