Long-term Follow-up Result after Selective Proximal Vagotomy for Duodenal Ulcer

Masaaki Nenohi, Tomoyoshi Atsuta, Noriyuki Itoh, Hohei Hishiyama, Koji Taira, Toru Nishiyama, Susumu Koshiko, Hiroyuki Katoh¹⁾, Tatsuzo Tanabe¹⁾

Department of Surgery, Asahikawa City Hospital
Second Department of Surgery, School of Medicine, Hokkaido University¹⁾

Of 67 patients who underwent selective proximal vagotomy (SPV) for duodenal ulcer and were followed for more than five years, the late postoperative state was analyzed in 66. There were six late deaths unrelated to ulcer disease. In eight patients (12.1%) recurrent ulcers were observed within 1 to 6 years after the initial operation. Locations of ulcer recurrence were the stomach in four and the duodenum in four. The time of ulcer recurrence ranged from 1∼10 years (median 5.7 years). Reoperation was necessary for three patients (4.5%), who received distal gastrectomy, and there were no recurrences after reoperation. Pentagastrin-stimulated maxium acid output was not reduced significantly after SPV in recurrent ulcer patients compared with those with no recurrence. The serum gastrin level tended to be higher in the postoperative than the preoperative state. Follow-up after a median of 8.8 years after SPV showed that Visick grade was I and II in 90% and their symptoms were slight if any.

Key words
selective proximal vagotomy, duodenal ulcer, recurrent ulcer, gastric acid analysis, Visick grade

Reprint requests
Masaaki Nenohi Department of Surgery, Asahikawa city Hospital
1 Kinsei-cho, Asahikawa, 070 JAPAN

Accepted
July 10, 1990

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