HIGHLY SELECTIVE LAPAROSCOPIC VAGOTOMY IN THE MANAGEMENT OF DUODENAL-ULCER AND GASTROESOPHAGEAL REFLUX - THE TECHNIQUE AND RESULTS IN 150 PATIENTS

Highly selective vagotomy is the surgical treatment of choice for duod enal ulcer, It is the procedure that best maintains digestive anatomy and physiology with very few side effects, and widely performed all ov er the world, It has also been employed to treat gastroesophageal refl ux for its many advantages: it reduces gastric acid output; it permits easy access to the gastroesophageal junction, assuring a precise, sec ure fundoplication, We have been using this technique in open surgery since 1978. This prospective study reproduces with laparoscopic guidan ce, the same technique we used to employ in open surgery, The purpose is to analyze the laparoscopic procedure and discuss the results in 15 0 patients who were treated between March 1992 and August 1996. This s eries deals with 36 patients with duodenal ulcer, 80 with gastroesopha geal reflux and 34 who presented both. All the duodenal ulcer patients were treated successfully, with no recurrences to date, Recurrences h ave been recorded in two complex cases of gastroesophageal reflux, The remaining patients show no clinical evidence of reflux and present no rmal endoscopic findings, esophageal manometric studies and 24-hour es ophageal pH measurements, Laparoscopic surgery with this technique app ears to be an interesting alternative to prolonged medical treatment o f these diseases in certain refractory patients.