[Recurrent postoperative ulcer]

Abstract

A total of 96 patients have been hospitalized over a period of 20 years, of which 89 had been operated for recidivating post-operative ulcer (RPOU). Particular clinical and etiopathogenic aspects are stressed, such as RPOU manifested exclusively by digestive haemorrhage, pseudo-tumoral RPOU, ulcers recidivating after exclusion resection, and multi-recidivating ulcers. Prophylaxis of RPOU is best achieved by a correct primary intervention for ulcers, and the prophylaxis of the recidives should be achieved by a correct re-intervention. This presumes that a correct resection, or a correct iterative resection should be performed, as well as a correct sub-diaphragmatic vagotomy. In recidivating post-operative ulcers on the duodenal stump an important element is the insufficiency of the resection on theright, and the value is stressed of an extended resection of the stump, associated to vagotomy. In multi-recidivating ulcers after repeated interventions that have been correctly performed, gastrectomy of the total type is considered the best solution.