caa a22 4500 475802519 CHVBK 20180406123741.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s002689910042 doi (NATIONALLICENCE)springer-10.1007/s002689910042 Johnson Alan G. Department of Surgery, University Surgical Unit, The Royal Hallamshire Hospital, Glossap Road, Sheffield S10 2JF, UK, GB aut Proximal Gastric Vagotomy: Does It Have a Place in the Future Management of Peptic Ulcer? [Elektronische Daten] [Alan G. Johnson] Proximal gastric vagotomy (PGV) is a modification of truncal vagotomy, which was introduced by Dragstedt for the treatment of duodenal ulcer (DU) in 1943. It is a technically demanding operation; but when performed by an experienced surgeon, it is safe and gives a cure rate for DU of more than 90%, with minimal side effects. The operation permanently alters the natural history of the disease and may be used for gastric ulcer (GU), with ulcer excision; but it is not as effective. Further adaptations, such as posterior truncal vagotomy with anterior seromyotomy, were introduced to simplify and shorten the operation, but they did not receive wide acceptance. Recently, with the identification of Helicobacter, it was found that DU can also be cured by eliminating the infection. PGV is therefore used electively in patients with persistent DU that is not Helicobacter-positive or in the few in whom Helicobacter cannot be eliminated. In patients with bleeding or perforated DUs, PGV may be used in conjunction with underrunning the vessel or patching the perforation. However, few surgeons doing emergency peptic ulcer surgery have experience with PGV, so simple suture followed by medical treatment is the safest option. Because elective PGV is now a rare procedure, patients should be referred to a center with special expertise. If Helicobacter becomes resistant to antibiotics in the future, surgery may be needed regularly again, but the technical nuances would have to be relearned. by the Société Internationale de Chirurgie, 2000 World Journal of Surgery Springer-Verlag 24/3(2000-03-01), 259-263 0364-2313 24:3<259 2000 24 268 https://doi.org/10.1007/s002689910042 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910042 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Johnson Alan G. Department of Surgery, University Surgical Unit, The Royal Hallamshire Hospital, Glossap Road, Sheffield S10 2JF, UK, GB aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/3(2000-03-01), 259-263 0364-2313 24:3<259 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer