An audit of peptic ulcer surgery in Ibadan, Nigeria

Abstract

Several operations are useful for peptic ulcer surgery, these include Vagotomy and pyloroplasty, Vagotomy and antrectomy, Vagotomy and gastrojejunostomy, and Highly Selective Vagotomy to name a few. Utilising any of these procedures may be due to the operator's preference or more importantly the suitability of the operation to the individual patient. This study was carried out to see the surgical presentation of chronic peptic ulcer disease patients and the form of ulcer-surgery utilised in the University College Hospital Ibadan, Nigeria. A retrospective study of all the patients who were operated on for complications of peptic ulcer disease between January 1990 and December 2003 at the above-mentioned institution by studying the case-files, ward admission records and operation room registers of such patients. There were 122 patients, 90 male and 32 female with a Male:Female ratio of 3:1. Pyloric stenosis accounted for 56.6% of patients followed by perforation (29.5%), bleeding (9.8%) and gastric ulcer (4.1%). Yearly presentations seem to be reducing. Truncal vagotomy and drainage was performed in 78.64% of the patients, simple closure for perforation in 29.5%, partial gastrectomy for 4.1% while the remaining 2.4% had underunning of a bleeding vessel. Pyloric stenosis (also called gastric outlet obstruction) is the most common surgical presentation of peptic ulcer disease in the University College Hospital Ibadan and Truncal Vagotomy and drainage is the most common surgical procedure performed for peptic ulcer.