Early postoperative period of vagotomy and bypass operation

Abstract

A study is carried out of the early post-operative of 34 patients operated upon at the Surgical Clinic "B" ( University Hospital, Montevideo), for a complicated or medically intractable duodenal ulcer. The operation consisted of non-selective vagotomy associated with pyloroplastic ( 27 cases), gastrojejunostomy ( 6 cases), and antrectomy with gastrojejunostomy
( 1 case). The series includes 2 perforated ulcers, 1 bleeding ulcer and 3 cases of postpy loric stenosis of ulcerous origin. The following conclusions were inferable:
1) Absence of operative and post-operative mortality.
2) Absence of post-vagotomy gastric retencion ( gastric atony) beyond the 5th. day.
3) Absence of failures in the pyloroplasty.
4) Absence of post-operative gastroduodenal hemorrage.
5) Subsidance of the pre-operative clinical symptomatology.
6) Occurrence of diarrhea in 35 % of cases and infectious complications ( wound suppuration, acute pne umopaty) in 38,2 % 0f cases. 

7) Clinical and X-ray evidence bears out the existence of a gastroduodena! dysfuntion during the first 2-4 post-operative days, marked by insufficient gastric drainage to the duodenum, ich renders necessary  gastric aspiration and support feeding by the parenteral or duodenal route. In case of preoperative suspi:cion of important gastric retencion ( large hydric  ypersecretories), a temporary degravitation gastrostomy is advised.