Original scientific articleComparative Analysis of Vagotomy and Drainage Versus Vagotomy and Resection Procedures for Bleeding Peptic Ulcer Disease: Results of 907 Patients from the Department of Veterans Affairs National Surgical Quality Improvement Program Database
Section snippets
Research protocol and study population
The research protocol was performed after approval by the Executive Committee in accordance with the NSQIP policies and the Durham Veterans Affairs Medical Center’s Institutional Review Board. Analysis of the data was done at the NSQIP Denver Data Analysis Center under supervision of a senior statistician (WGH). The data set used was a compilation of procedures from assessed patients in the database from fiscal years 1991 to 2001 (fiscal year is October 1 to September 30). Surgical patients
Results
From the information on 3,698 patients obtained from the NSQIP data set who required surgery for peptic ulcer, 907 had been operated on for bleeding PUD. Fifty-seven percent of these (n = 518) were categorized in the vagotomy and drainage (VD) group; the remaining 43% (n = 389) were vagotomy and resection (VR) patients. The majority of patients in both study groups were Caucasian, with an average 28% of non-Caucasian individuals (ie, NSQIP defines non-Caucasian, as Hispanic Caucasian; Hispanic
Discussion
With the nearly ubiquitous use of potent antiulcerogenic drugs and improved endoscopic tools, the need for elective surgery in PUD has declined. After initial resuscitative measures and endoscopic therapy, the majority of patients can be managed successfully, and the indication for surgery has been narrowed to patients in whom aggressive medical management has not been successful. Among all complications of PUD, intractable bleeding is a common indication for surgical intervention.15 In this
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Competing Interests Declared: None.