Evaluation of Proximal Gastric Vagotomy During a 10-Year Period

Peptic ulcer is one of the most common gastrointestinal diseases. Among the three recommended surgical methods for this problem, highly selective vagotomy with less than 0.5% mortality rate, has the fewest side effects. Due to absence of documented reports, this study aims to investigate the risk factors and promote prognosis in patients undergoing proximal vagotomy during a 10-year period.

Highly selective vagotomy was performed in 45 patients during 10 years. Endoscopy was carried out three to six months after surgery. Thereafter, endoscopy results and the patients’ symptoms such as abdominal pain, bleeding, gastric outlet obstruction, weight gain or loss, patients’ demographics, and the reason for referral were gathered and analyzed.
FINDINGS: Generally, 36 out of 45 patients were male (80%), and the mean age of the patients was 39.29±11.51 years. Among these patients, 40 (88%) suffered from obstruction and in 40 (88%) of them, no signs were detected during reexamination. Marginal ulcers were observed in two (4.4%) patients and a new duodenal ulcer was observed in one (2.2%) of the participants. The final diagnosis for two patients (2.2%) who underwent surgery due to obstruction was cancer.

Our study shows that highly selective vagotomy has low side effects and rate of recurrence, and in spite of negative biopsy results for elderly patients, the likelihood of cancer must be considered.