||Highly selective vagotomy and digital dilatation for stenosing duodenal ulcer - abstract|
||West Indian med. j;33(Suppl):33, 1984.
||Present in: 29th Scientific Meeting of Commonwealth Caribbean Medical Research Council, s.l, April 25-28, 1984.
||Twenty-eight patients (24 males and 4 females) with pyloroduodenal obstruction due to chronic duodenal ulcer had highly selective vagotomy (HSV) alone (6/28) or HSV and digital dilatation (DD) of stenosis (22/28), 1 to 4 years previously. Their ages ranged from 19 to 61 years, with a mean of 42 years. There was no post-operative death. One patient had perforation of the duodenum during dilatation. The only patient with Hb SS disease, a male aged 49, died from haemorrhage and perforation of recurrent ulcer 1 year after surgery. Two other males had easily controllable recurrent duodenal ulcers, but no stenosis. Another male died of unrelated cause after two symptom-free years. Six males were re-operated on for symptoms of gastric stasis. Only 3 of these were found to have complete fibrous stenosis for which gastro-enterostomy was done. The other three had adequate pyloroduodenal lumen. Patients with inflammatory stenosis do well after HSV and DD, but this combined procedure should be avoided in fibrous tissue stenosis (AU)|
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