[The surgical treatment results of ulcerous pyloro-duodenal stenosis: about 160 cases].

OBJECTIVE

To evaluate the outcomes of the surgical treatment of ulcerous pyloro duodenal stenosis at Dakar.

PATIENTS AND

METHODS

We carried out a retrospective study including 160 medical records of patients presenting an ulcerous pyloroduodenal stenosis from January 2000 to December 2006. After a mean follow up of 16 months, surgical outcomes were evaluated including mortality and morbidity. The functional results were evaluated using Visick Classification.

RESULTS

The mean age of our patients was 42 years and 6 months (range: 17-20 years). Our population included 126 men (78,7%) and 34 women (21,3%). Oeso-gastro-duodenal fibroscopy was performed in 136 patients (85%) whereas barium meal was carried out in 82 patients (51,25%). Surgical approach was laparoscopy in 132 cases (82%) and laparotomy in 28 cases (18%). All patients underwent a troncular vagotomy. In addition a gastroentero anastomosis was performed in 89,2% of cases, a pyloroplasty in 10% of cases and an antrectomy in 0,6% of cases. Mortality rate was 0%. The morbidity rate was 10% including parietal suppuration, diarrhoea and hiccups. Functional outcomes were as follows: Visick I in 91% of cases, Visick II in 6,3% of cases and Visick III in 2,7%.

CONCLUSION

Ulcerous pyloro duodenal stenosis is a frequent complication of ulcer disease. Its treatment is surgical based on a vagotomy with gastric discharge. The outcomes are satisfactory in our context.