PROSPECTIVE RANDOMIZED STUDY COMPARING 3 SURGICAL TECHNIQUES FOR THE TREATMENT OF GASTRIC OUTLET OBSTRUCTION SECONDARY TO DUODENAL-ULCER

A prospective randomized clinical trial was performed in order to eval uate the results of three surgical techniques for the treatment of gas tric outlet obstruction secondary to duodenal ulcer. Ninety patients w ith clinical and laboratory evidence of gastric retention were enrolle d. After laparotomy, patients underwent either highly selective vagoto my (HSV) + gastrojejunostomy, HSV + Jaboulay gastroduodenostomy, or se lective vagotomy (SV) + antrectomy. One patient died after HSV + jabou lay gastroduodenostomy due to postoperative acute pancreatitis. There were no differences in the postoperative course of the three groups. P atients were followed for a mean of 98 months (range: 30 to 156 months ). There was a significantly better result after HSV + gastrojejunosto my than after Jaboulay anastomosis (p <0.01), but not after SV + antre ctomy. Gastric acid reduction was similar in the small group of patien ts studied. We propose HSV + gastrojejunostomy as the treatment of cho ice in patients with duodenal ulcer and gastric outlet obstruction.