Selection of duodenal ulcer subjects for surgical vagotomy on the basis of medical vagotomy
Pimparkar, B.D.; Bhalerao, R.A.; Donde, U.M.
Indian Journal of Medical Research 66(3): 449-459
1977
ISSN/ISBN: 0019-5340 PMID: 598918 Document Number: 114861
In order to reduce the failure in surgery and to find out the type of surgery best suited to an individual, the utility of preoperative augmented histamine test (AHT) and medical vagotomy with 12 mg of atropine given s.c. twice during repeat AHT, for selection for surgical vagotomy was evaluated preoperatively in 25 normal controls and 140 male duodenal ulcer patients. Fifty two of the 140 patients were subsequently operated. There was significant suppression of acid and pepsin in the normal control and duodenal ulcer patients with atropine at the basal state as well as after maximal stimulation with histamine. A prediction of post operative gastric acid and pepsin output could be made with a high degree of accuracy from the results of preoperative AHT and medical vagotomy in the majority of these patients. A method of selection of the surgical procedure for duodenal ulcer subjects on the basis of preoperative response to AHT and atropine tests was suggested.