Patient presents with recurrent duodenal ulcer of 2.5 cm size; procedure of choice
Answer is A (Truncal vagotomy and antrectomy): The question here Strictly specifies recurrence as the major problem 'Recurrent duodenal ulcer'. Hence a procedure with the minimum recurrence rate, would logically be, the best operation. Truncal vagotomy and antrectomy are associated with minimum recurrence rate and is the answer of choice. Note: Operation with maximum Operation with minimum The most widely used procedure in India reduction in acid production operative moality Truncal vagotomy and Highly selective vagotomy Truncal vagotomy plus a drainage procedure Gasirojejunostomy antrectomy is at present the most widely used procedure. Highly selective vagotomy: - In highly selective vagotomy nerves of Latarjet supplying the antrum are preserved.Q- A drainage procedure is not required Q - Operation moality is lower than in any other definitive operation for duodenal ulceration. Q
Truncal vagotomy and antrectomy
Truncal vagotomy and gastrojejunostomy
Highly selective vagotomy
Laparoscopic vagotomy and gastrojejunostomy