BILLROTH-I-HEMIGASTRECTOMY FOR COMPLICATE D ULCER RECURRENCE AFTER PROXIMAL SELECTIVE VAGOTOMY

The outcome of Billroth I hemigastrectomy for complicated recurrent ul cers after proximal selective vagotomy (PSV) for duodenal ulcer was an alyzed in a retrospective study of 15 patients followed up for 15-81 m onths (mean 3.8 years) postoperatively. Bleeding was reported in 4, st enosis in 5, penetration in 3, perforation in 1 and refractory ulcer i n 2 cases. None of the patients died during revision surgery, and none developed ulcer recurrence. In 4 patients complications were seen, in cluding bleeding requiring relaparotomy (1) and subhepatic hematoma (3 ). In 12 patients (80%) a good or excellent result (Visick I/II) was s een at follow-up. Reasons for Visick III or Visick IV classification w ere reflux esophagitis grades I and II in 2 cases and refractory dyspe ptic symptoms in 1 case. Distal gastric resection with a Billroth I an astomosis for complicated recurrent ulcer after PSV proved to involve only low morbidity and to effect reliable prophylaxis of ulcer recurre nce in the long term.