教室における消化性潰瘍に対する外科的治療の変遷 ：H₂受容体拮抗剤導入前後を比較して

Abstract

This study was undertaken to investigate changes in the surgical treatment of peptic ulcer disease in our clinic before (the first period : 1975-81) and after (the latter period : 1982-88) introduction of H₂-receptor antagonists. 1. The number of surgically treated peptic ulcer cases decreased by 66% from the first period to the latter period, that was mainly due to the decrease of the number of surgically treated intractable ulcer cases. 2. The number of cases operated on for complications decreased slightly as a whole, but the number of cases operated on for stenosis increased in the latter period. 3. The ratio of patients over sixty years old and the ratio of females of the first period increased about two times as much as that of the latter period. 4. About the location of peptic ulcer, gastroduodenal ulcer showed highest rate of decrease from the first period to the latter period. 5. Most useful surgical procedures in the first period were pylorus preserving gastrectomy (PPG) for gastric ulcer, selective vagotomy with antrectomy (SV + A) for duodenal ulcer, and selective vagotomy vith hemigastrectomy (SV + H) for gastroduodenal ulcer. In the latter period these were gastric resection for gastric ulcer, SV + A for duodenal ulcer, and both SV + A and gastric resection for gastroduodenal ulcer.