Pyloroplasty alone in the management of patients with a negative exploration for duodenal ulcer

Abstract

If a preoperative diagnosis of duodenal ulcer in not confirmed at laparotomy an exploratory pyloroduodenotomy may be closed as a pyloroplasty without adding a vagal section. This study concerns 32 patients in whom this was done. As a group these patients tended to have somewhat atypical ulcer symptoms and indefinite radiological sings. Within a mean follow-up period of 3 1/2 years more than one-third of these patients developed recurrent ulcer symptoms, which in 4 patients ot date have been successfully treated by vagotomy. The functional result could not be predicted by the preoperative symptoms or radiological changes. The incidence of diarrhoea and post-cibal fullness, vomiting, dumping, colic, and hypoglycaemia was almos identical with that seen after vagotomy and pyloroplasty. The wisdom of using pyloroplasty without vagotomy in patients with ulcer symptoms is therefore questioned.