Laparoscopic surgery for duodenal ulcer: first results of a multicenter study applying a personal procedure.

Background/aims: First results from 14 different centers applying a personal procedure for the treatment of duodenal ulcer by laparoscopic surgery.

Methodology: One hundred and thirty-six patients were operated on in 14 surgical centers between January 1991 and February 1995. All patients underwent posterior truncal vagotomy (PTV) and anterior linear gastrectomy (ALG) for chronic duodenal ulcer.

Laparoscopy and septic dissemination caused by perioperative perforation of the occluded small bowel: an experimental study.

Based on the observation of septic shock and severe respiratory impairment in two patients subjected to laparoscopic surgery for small bowel occlusion, an experimental study was carried out in rabbits to evaluate the effect of intra-abdominal CO2 hyperpressure on massive bacterial spread. Increased bacterial access to the blood was observed as a result of the mechanical effect of the hyperpressure associated with the highly septic contents of the occluded bowel. The important risk of bacterial dissemination following accidental peroperative perforation requires extreme caution in the laparoscopic management of late occlusions of the small intestine.

Laparoscopic surgery for duodenal ulcer: first results of a multicentre study applying a personal procedure.

Between January 1991 and February 1995 data were gathered on 136 patients operated on in 14 surgical centres. All patients underwent posterior truncal vagotomy (PTV) and anterior linear gastrectomy (ALG) for chronic duodenal ulcer. Recurrence and repeated bleeding were the main indications for surgery.

[Nerve regeneration in the anterior gastric wall after gastrotomy and posterior truncal vagotomy in the rat].

A study was made to compare nerve regeneration of the anterior gastric wall following either seromyotomy or gastrotomy with eversion suturing; both approaches extending from the antrum to the fundus. Twenty-eight preadult Wistar rats were divided into three groups: Group I (control: sham operated animals; n = 8); Group II (seromyotomy with posterior truncal vagotomy; n = 10); and Group III (gastrotomy with posterior truncal vagotomy; n = 10). Nerve regeneration was evaluated immunohistochemically two months after the operation.

[Reoperations after esophagomyotomy in esophageal motility disorders].

Out of 96 patients with the diagnosis of primary esophageal motor disorders and treated by esophagomyotomy, a group of 9 patients is reported in whom reoperation was necessary because of persistence or worsening of the previous symptoms (8 patients) or persistent reflux esophagitis (one patient). Clinical and laboratory examinations together with the operative findings allowed classification of these patients: incomplete myotomy proximally (4 patients) or distally (one patient), fibrotic scar at the site of previous myotomy (2 patients), persistence of intact muscle fibers (one patient) and reflux esophagitis for lack of an antireflux intervention during myotomy. Treatment consisted of completing myotomy proximally or distally, resection of the fibrous tissue and an antireflux operation when indicated.