소화성 궤양의 수술적 요법에 따른 치료성적의 비교연구

• Published in: The Korean journal of gastroenterology Vol. 27; no. 6; pp. 626 - 634
• Main Authors: 허경열, Kyung Yul Hur, 송태건, Tae Geon Song, 박경규, Kyung Kyu Park, 송영식, Young Sik Song, 김익수, Ik Soo Kim
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 01.01.1995
• Subjects: Complication; Peptic ulcer; Surgery
• ISSN: 1598-9992

Background/Ainis: We planed the study to evaluate the ideal procedure in surgical aspect of peptic ulcer through comparision of results in each procedure. Methnds: we reviewed l47 patients treated during l987 to 1993 at department of surgery, Socmchunhyang University Hospital. Results: The indications of operation were perforation(63.3%), obstruction(17.7%), bleeding(15.0%), intractabi- lity(2.0%) and others(2.0%) in order of frequency. Truncal vagotomy and pyloroplasty was perfor- med in 70 patients(47.6%), truncal vagotomy and antrectomy in 27 patients(18.4%), subtotal gastrectomy in 19 patients(I2.9%), truncal vagotomy and gastrojejunostomy in 15 patients(l0.2%.), primary closure in 10 patients(6.8%) and other procedures in 6 patients(4.1 fo). Perioperative morta- lity rate was l.4%(2 patients1 tha( these patients have severe and uncontrolled medical illness. Among 147 cases, follow-up evaluation was possible in 83 cases. The 66 cases(79.6%) was classified excellent and very good group according to Golighers modified Visick classification. In this study, ulcer recurrence rate was as follows: tnmcai vagotomy and antrectomy 0 "il,, truncal vagotnmy and pyloroplasty 7.9%, subtotal gastrectomy 9.1Fo, truncal vagotomy and gastrojejunos- tomy 22.2%, and primary closure 60.0%. Reoperation was necessary in 4 cases after antrectomy and truncal vagotomy(14.8'7c), l patient after truncal vagotomy and pyloroplasty(1.5Fo) and 2 cases after truncal vagotomy and gastrojejunostomy(l3.3%). Conclusions: Considering postoperative complication and reoperation rate, we conclude that truncal vagotomy and pyloroplasty was more acceptable and safe procedure than truncal vagotomy and antrectomy in perforated peptic ulcer, even though its re]atively higher recurrence rate. (Korean J Gastroenterol 1995;27: 626-634)