Abstract

TORRES PENA, Rafael et al. Laparoscopic treatment of peptic duodenal ulcer: Long-term results. Rev haban cienc méd [online]. 2009, vol.8, suppl.5. ISSN 1729-519X.

Although elective surgery for duodenal ulcer is less frequent today, the indications for surgical treatment remain the same and there is still a small proportion of patients who should be considered for surgical treatment. The Taylor's procedure (posterior truncal vagotomy with anterior gastric seromiotomy) and the Hill-Barker's procedure (posterior truncal vagotomy with anterior highly selective vagotomy) have been the most accepted modalities of vagotomies when they have been performed by laparoscopy because of their efficacy, safety and simplicity. The objective of this study was to evaluate the long-term results of these laparoscopic techniques. 183 consecutive patients receiving either Taylor (n=75) or Hill-Barker (n=103) procedures at National Center for Minimal Access Surgery between 1994 and 2001, were prospectively followed for 1 to 80 (mean, 52) month to assess their outcomes. Factors related to feasibility, safety and long-term functional result, like operative time, mortality, morbidity, side effects of operation and recurrence, were analyzed during the follow-up.The mean operative time was 116,3 minutes for Hill-Barker's procedure and 149.2 minutes for Taylor's procedure. Our results show no operative mortality and no conversion to an open procedure. Hospital stay was 2.1 days. Diarrhoea (10,9%) and delayed gastric emptying (4,4%) were the most frequent complications. The global rate of recurrent ulceration was 10.4% The low rates of mortality, recurrence and functional disorders at long-term, added to the advantages of minimal invasive surgery confers to laparoscopic vagotomies the condition of ideal treatment for duodenal ulcer, when surgical treatment is indicated.

Keywords : laparoscopic vagotomy; duodenal ulcer; Hill-Barker's procedure; Taylor's procedure..

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