Surgery For Peptic Ulcers

In most cases, anti-ulcer medications heal the ulcers quickly and effectively. Eradication of H. pylori prevents most ulcers from recurring. Surgical intervention is rare. However, some people do not respond to antibiotics prescribed to heal the ulcer, or they develop complications from the ulcers such as perforation, bleeding, and obstructions. They may require surgical intervention.

The types of surgery that may be performed for ulcers are vagotomy, pyloroplasty, and antrectomy.

Vagotomy

In this surgery the vagus nerve, which transmits messages from the brain to the stomach, is cut. Interrupting these messages reduces acid secretion. However, there can be side effects such as severe, persistent abdominal pain, vomiting, or diarrhea. The surgery may also interfere with stomach emptying. The newest variation of this surgery involves cutting the only parts of the nerve that control the acid-secreting cells of the stomach. This avoids the parts of the nerve that influence stomach emptying.

Antrectomy

In this surgery, the lower part of the stomach (antrum) is removed. This section of the stomach produces a hormone that stimulates the stomach to secrete digestive juices. Sometimes a surgeon may also remove an adjacent part of the stomach that secretes pepsin and acid. A vagotomy is usually done in conjunction with an antrectomy.

Pyloroplasty

This surgery enlarges the opening to the duodenum and small intestine (pylorus), which enables stomach contents to pass more freely out of the stomach. A vagotomy may also be performed along with a pyloroplasty.

_{Sources:
"Common GI Problems: Volume 1." American College of Gastroenterology. 22 Aug 2007}

"H. pylori and Peptic Ulcer." NIH Publication No. 05–4225 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 22 Aug 2007

"What I need to know about Peptic Ulcers." NIH Publication No. 05–5042 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 22 Aug 2007

William D. Chey, M.D., F.A.C.G., A.G.A.F., F.A.C.P., Benjamin C.Y. Wong, M.D., Ph.D., F.A.C.G., F.A.C.P., "American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection." doi: 10.1111/j.1572-0241.2007.01393.x. American College of Gastroenterology. 22 Aug 2007