Journal - East African medical journal (KENYA )

Abstract :

During the period which comprised this study, September 1973 to August 1980, 346 patients were operated on for duodenal ulcer. 230 patients whose charts could be retrieved were retrospectively analysed. The diagnosis was confirmed by barium meal in 168 patients and endoscopy in 57 cases, and all were operated by the staff of the department. The peak age incidence was 30 to 40 years with male to female ratio of 5:1, a sex proportion more consistent with that usually reported for duodenal ulcer in the west. Although pyloric stenosis was relatively more observed among peasant farmers, no preferential predilection to any other professional group was noticed. The commonest surgical indication was gastroduodenal obstruction. Truncal vagotomy and drainage was performed in 178 (77.4%) patients. Follow up of patients was extremely difficult and therefore only two thirds could be followed for about 24 months. In these, dumping was present in 4 (2.60%) patients; diarrhoea in 2 (1.30%) patients, and a recurrence of ulcer in 5 (3.40%) patients. It is to be concluded that truncal vagotomy and gastric drainage is a satisfactory modality of therapy for chronic duodenal ulcer in general and pyloric stenosis in particular since this can be accomplished with an acceptable morbidity and mortality.