Laparoscopy versus open surgery in truncal vagotomy with gastrojejunostomy for peptic pyloric stenosis: a retrospective study of 151 patients

Abstract

Background

Peptic ulcer disease continues to be a major health concern. Surgical intervention is usually reserved for complications, such as pyloric stenosis, leading to gastric outlet obstruction. We compared the outcomes of laparoscopic and open surgery.

Materials and methods

This is a retrospective study comparing Laparoscopic Truncal vagotomy and Gastrojejunostomy with open procedure. We examined the medical records of 151 patients treated for peptic pyloric stenosis at La Rabta Hospital in Tunis, Tunisia, from January 2000 to December 2018. The study focused on benign gastric outlet obstruction due to peptic ulcer disease, with patient progress monitored for over 24 months.

Results

A hundred and fifty-one patients treated for peptic ulcer stenosis by gastojejunostomy and truncal vagotomy were included in the study, featuring 52 cases of LTVGJ 99 cases ofOTVGJ. The male-to-female ratio was 5.2, with a mean age of 48 years for both groups. Perioperative outcomes revealed that OTVGJ had a shorter mean operative time (95 min) compared to LTVGJ (115 min), while the median hospital stay was longer for OTVGJ (7.9 days) versus LTVGJ (5.5 days). Both groups exhibited similar rates of delayed gastric emptying and postoperative gastrointestinal symptoms, with no cases of leakage or operative mortality. Diabetes was the only significant risk factor for delayed gastric emptying.

Conclusion

Laparoscopic truncal vagotomy and gastrojejunostomy for gastric outlet obstruction secondary to peptic ulcer disease is a safe and effective modality, offers low morbidity and satisfactory clinical status on long term follow up.