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Surgical Options for Severe or Recurrent Peptic Ulcers

Peptic ulcers are open sores that develop on the lining of the stomach, upper small intestine, or esophagus. While most peptic ulcers can be effectively treated with medications and lifestyle changes, severe or recurrent ulcers may require surgical intervention.

1. Vagotomy

Vagotomy is a surgical procedure that involves cutting or removing a portion of the vagus nerve, which controls the production of stomach acid. By reducing the stimulation of acid secretion, vagotomy helps to prevent the formation of new ulcers and promote the healing of existing ones.

There are different types of vagotomy procedures, including:

• Truncal vagotomy: In this procedure, the main branches of the vagus nerve are cut.
• Highly selective vagotomy: This procedure selectively cuts only the nerves that supply the acid-producing cells of the stomach, preserving other functions of the vagus nerve.
• Superselective vagotomy: This advanced technique involves cutting only the specific nerve fibers that supply the acid-producing cells, leaving other nerve fibers intact.

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2. Antrectomy

Antrectomy is a surgical procedure that involves removing the lower part of the stomach called the antrum, which is responsible for producing gastrin, a hormone that stimulates acid secretion. By removing the antrum, antrectomy reduces the production of stomach acid, helping to prevent the recurrence of peptic ulcers.

3. Gastrectomy

Gastrectomy is a surgical procedure that involves removing a portion or the entire stomach. This procedure is typically reserved for severe cases of peptic ulcers that do not respond to other treatments. Gastrectomy may be performed as a last resort to eliminate the source of acid production and prevent further ulcer formation.

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4. Gastric Bypass Surgery

Gastric bypass surgery is a weight loss procedure that can also be beneficial for individuals with severe or recurrent peptic ulcers. This surgery involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing the rest of the stomach. By reducing the amount of acid exposure to the stomach lining, gastric bypass surgery can help heal existing ulcers and prevent new ones from forming.

It is important to note that surgical options for peptic ulcers are typically considered when other conservative treatments have failed or when complications such as bleeding, perforation, or obstruction occur. The choice of surgical procedure depends on the individual’s specific condition and should be discussed with a qualified healthcare professional.

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Keywords: ulcers, stomach, procedure, surgical, peptic, vagotomy, involves, severe, removing