Vagotomie Tronculaire Et Drainage Gastrique Coelio-Assistés Pour Ulcère Duodénal Sténosant
Vagotomie Tronculaire Et Drainage Gastrique Coelio-Assistés Pour Ulcère Duodénal Sténosant
Vagotomie Tronculaire Et Drainage Gastrique Coelio-Assistés Pour Ulcère Duodénal Sténosant
Ousmane Kâ*, Mamadou Cissé*, Madieng Dieng*, Azza Sridi*, Ibrahima Konaté*, Mamadou
Lamine Diouf**, Abdarahmane Dia*, Cheikh Tidiane Touré*.
*Service de chirurgie générale, CHU A Le Dantec, Dakar, Sénégal.
**Service d’hépato-gastroentérologie, CHU A Le Dantec, Dakar, Sénégal.
Keywords Abstract
Troncular vagotomy Introduction: Duodenal peptic ulcer obstruction become rare in developed countries but remains frequent in
video-assisted gastric underdeveloped countries where the surgical treatment was based for a long time on troncular vagotomy and
drainage gastric drainage performed by laparotomy. The objective of our study is to report the results of our technique of
duodenal peptic ulcer video-assisted troncular vagotomy and gastric drainage, in a context of minimal equipment.
Patients and methods: We did a prospective study undertaken over 4 years, related to patients presenting a
duodenal peptic ulcer obstruction. They were 38 men and 16 women 38.5 years old on average. Vagotomy was
entirely done by cœlioscopic way. Gastrojejunostomy was carried out among 48 patients by a 6 cm mini median
laparotomy above umbilicus and pyloroplasty among 6 patients by a 5 cm mini incision under costal right-hand
side.
Results. The average duration of the coelioscopy was 75 minutes. Conversion into laparotomy had intervened at
7.4% of the patients because of adherences, hypertrophy of the left lobe of the liver, absence of identification
of the posterior vagus nerve and wound of the esophagus. There were residual pains at 11.1% of the patients.
Among 3 patients (5.5%) the pyloroplasty was not functional and was treated by a gastrojejunostomy. Morbidity
was 7.4% and there was no mortality. We did not observe recurrence of peptic ulcer nor obstruction remotely.
Conclusion. In a context of minimal equipment, video-assisted troncular vagotomy and gastric drainage constitu-
tes an appropriate mini invasive procedure to treat duodenal peptic ulcer obstruction with encouraging results.
Correspondance :
Docteur Ousmane Kâ.
Service de chirurgie générale, CHU A Le Dantec, BP 6958- Dakar-Etoile, Dakar, Sénégal.
Email : ousmaneka@yahoo.fr