Mäkelä J T, Kiviniemi H, Laitinen S
Department of Surgery, Oulu University Hospital, Finland.
Hepatogastroenterology. 1996 May-Jun;43(9):547-52.
BACKGROUND/AIMS: This study assessed the changes in the pattern of operation rates and operations performed for gastric outlet obstruction due to peptic ulcer disease in a well-defined population in northern Finland.
The data from 99 patients recorded during 1977-1994 were analyzed.
The overall operation rate was low with a slight variation ranging annually from 1.1 to 3.0 per 10(5) inhabitants. The male-female ratio was 54/45 with no significant changes during the study period. Duodenal ulcer caused annually more gastric outlet obstructions than gastric ulcer, except in the year 1994. Old women were frequently operated on for obstructing ulcer (p < 0.034). The overall mortality after operations performed for obstruction was 5%, and the mean age of the fatalities (68 +/- 9) was significantly higher than that of those who survived (54 +/- 15) (p < 0.042). The high rate of restenosis, 43% (5/12), occurring after proximal gastric vagotomy with pyloroduodenal dilatation, does not justify this procedure for gastric outlet obstruction.
The good results obtained after antrectomy with selective vagotomy encourage us to use it as the main procedure for gastric outlet obstruction. It is concluded that the incidence of operations performed for obstructing peptic ulcer has not decreased during last 18 years.
