Highly selective vagotomy plus Jaboulay: a possible alternative in patients with benign stenosis secondary to duodenal ulceration.

BACKGROUND

The treatment of patients with duodenal ulcers has undergone radical changes in recent years. Symptomatic stenotic obstruction of the gastric outlet, however, has remained a specific indication for elective operation, with gastric resection (Billroth I or II) and vagotomy often used as options for intervention.

STUDY

DESIGN

The present report describes the results of highly selective vagotomy (HSV) in combination with lateral Jaboulay gastroduodenostomy in the treatment of patients with benign stenosis secondary to duodenal ulceration. Functionality of results and patient satisfaction have been focal aspects in our assessment.

RESULTS

During a period of five years, HSV plus Jaboulay was performed upon 19 patients (14 men and five women, with an average age of 55 years). No operative mortality was seen. The postoperative follow-up period ranged from 12 to 60 months. There were no ulcer recurrences, the functional results (roentgenographic double-contrast technique) were excellent, and patient satisfaction was high (Visick grade I, 67 percent; Visick grade II, 33 percent).

CONCLUSIONS

As evidenced by the results, HSV plus Jaboulay seems to represent a convincing alternative to gastric resection in the treatment of patients with benign stenosis secondary to duodenal ulceration.