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 undergo ne radical changes in recent years, Symptomatic stenotic obstruction o f the gastric outlet, however, has remained a specific indication for elective operation, with gastric resection (Billroth I or II) and vago tomy often used as options for intervention. STUDY DESIGN: The present report describes the results of highly selective vagotomy (HSV) in co mbination with lateral Jaboulay gastroduodenostomy in the treatment of patients with benign stenosis secondary to duodenal ulceration. Funct ionality of results and patient satisfaction have been focal aspects i n our assessment. RESULTS: During a period of five years, HSV plus Jab oulay was performed upon 19 patients (14 men and five women, with an a verage age of 55 years). No operative mortality was seen. The postoper ative follow-up period ranged from 12 to 60 months. There were no ulce r recurrences, the functional results (roentgenographic double-contras t technique) were excellent, and patient satisfaction was high (Visick grade I, 67 percent; Visick grade II, 33 percent). CONCLUSIONS: As ev idenced by the results, HSV plus Jaboulay seems to represent a convinc ing alternative to gastric resection in the treatment of patients with benign stenosis secondary to duodenal ulceration.