Staged antrectomy and thoracoscopic truncal vagotomy for perforated peptic ulcer disease. 1993

T C Axford, and D G Clair, and M M Bertagnolli, and S J Mentzer, and D J Sugarbaker
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.

We report the case of a 40-year-old man with a perforated duodenal ulcer who underwent antrectomy at laparotomy, and in whom standard truncal vagotomy was not technically possible due to an intraabdominal abscess. Thoracoscopic truncal vagotomy performed at the level of the inferior pulmonary vein was successful in completely eliminating symptoms due to peptic ulcer disease without producing clinically significant morbidity. The minimal morbidity and short hospital stay suggest that thoracoscopic truncal vagotomy provides a reasonable alternative in patients with complicated intraabdominal abscesses due to peptic ulcer disease.

UI MeSH Term Description Entries
D008297 Male Males
D010439 Peptic Ulcer Perforation Penetration of a PEPTIC ULCER through the wall of DUODENUM or STOMACH allowing the leakage of luminal contents into the PERITONEAL CAVITY. Peptic Ulcer Perforations,Perforation, Peptic Ulcer,Perforations, Peptic Ulcer,Ulcer Perforation, Peptic,Ulcer Perforations, Peptic
D011706 Pyloric Antrum The region between the sharp indentation at the lower third of the STOMACH (incisura angularis) and the junction of the PYLORUS with the DUODENUM. Pyloric antral glands contain mucus-secreting cells and gastrin-secreting endocrine cells (G CELLS). Antrum, Pyloric,Gastric Antrum,Antrum, Gastric,Antrums, Gastric,Antrums, Pyloric,Gastric Antrums,Pyloric Antrums
D004381 Duodenal Ulcer A PEPTIC ULCER located in the DUODENUM. Curling's Ulcer,Curling Ulcer,Curlings Ulcer,Duodenal Ulcers,Ulcer, Curling,Ulcer, Duodenal,Ulcers, Duodenal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013906 Thoracoscopy Endoscopic examination, therapy or surgery of the pleural cavity. Endoscopy, Pleural,Pleural Endoscopy,Pleuroscopy,Surgical Procedures, Thoracoscopic,Thoracoscopic Surgical Procedures,Surgery, Thoracoscopic,Thoracoscopic Surgery,Endoscopies, Pleural,Pleural Endoscopies,Pleuroscopies,Surgeries, Thoracoscopic,Surgical Procedure, Thoracoscopic,Thoracoscopic Surgeries,Thoracoscopic Surgical Procedure,Thoracoscopies
D015167 Vagotomy, Truncal Bilateral dissection of the abdominal branches of the vagus nerve. It is used frequently in the surgical management of duodenal and gastric ulcers, as well as in physiologic studies of gastrointestinal secretion and motility. Truncal Vagotomy,Truncal Vagotomies,Vagotomies, Truncal

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