Highly selective vagotomy and gastrojejunostomy in the treatment of peptic ulcer induced gastric outlet obstruction

Nebojša Radovanović; Aleksandar Simić; Ognjan Skrobić; Milutin Kotarac; Nenad Ivanović

doi:10.2298/4716

Nebojša Radovanović Clinic for Digestive Disease – The First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Aleksandar Simić Clinic for Digestive Disease – The First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Ognjan Skrobić Clinic for Digestive Disease – The First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia
Milutin Kotarac Clinic for Digestive Disease – The First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia
Nenad Ivanović Clinic for Digestive Disease – The First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia

DOI: https://doi.org/10.2298/4716

Keywords: peptic ulcer, pyloric stenosis, vagotomy, proximal gastric, digestive system surgical procedures, treatment outcome,

Abstract

Background/Aim. The incidence of peptic ulcer-induced gastric outlet obstruction is constantly declining. The aim of this study was to present our results in the treatment of gastric outlet obstruction with highly selective vagotomy and gastrojejunostomy. Methods. This retrospective clinical study included 13 patients with peptic ulcer – induced gastric outlet obstruction operated with higly selective vagotomy and gastrojejunostomy. A 3-year follow-up was conducted including clinical interview and upper gastrointestinal endoscopy on 1 and 3 years after the surgery. Results. The most common preoperative symptom was vomiting (in 92.3% of patients). The mean preoperative body mass index was 16.3 ± 3.1 kg/m², with 9 patients classified preoperatively as underweight. There were no intraoperative complications, nor mortality. At a 3-year follow-up there was no ulcer recurrence. Delayed gastric emptying was present in 1, bile reflux in 2, and erosive gastritis in 1 patient. Two patients suffered from mild “dumping” syndrome. Conclusion. Higly selective vagotomy combined with gastrojejunostomy is a safe and easily feasible surgical solution of gastric outlet obstruction induced by peptic ulcer. Good functional results and low rate of complications can be expected at a long-term follow-up.

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