Truncal vagotomy with mucosal pyloroplasty in the treatment of chronic duodenal ulcer

23 patients with chronic duodenal ulcer represented the subject of this study. Their ages ranged between 26 and 58 years with a mean of 42.8 years. Truncal vagotomy and mucosal pyloroplasty was done. The indication of surgery was medical intractability and complications of ulcer. All patients were operated upon at Al Zahraa University Hospital. Mucosal pyloroplasty was done by suturing the mucosa only and leaving the muscle layer unsutured so that complete muscle relaxation at the pyloric sphincter is achieved allowing adequate drainage from the stomach. There was no intraoperative difficulty even in obese patients. No mortality and none suffered from dumping, or fistula formation. Mucosal pyloroplasty is a simple, quick, safe and easy to perform with good results even in the presence of fibrosis. We recommend more studies to properly place this procedure as the st and ard drainage procedure

Current concept of nutritional support after gastrointestinal surgery

In patients who have had major surgery or trauma, early enteral feeding is safer and more effective than parenteral or nasogastric feeding but is frequently associated with diarrhea. Limited recordings have shown that the patterning of duodenal interdigestive motor activity is frequently abnormal after surgery or in patients who are critically ill. The aim of the present study was to evaluate and compare the effects of postoperative administration of sufficient amounts of protein and calories, provided in the three different methods namely, total parenteral nutrition, total enteral nutrition, and a new method consisting of the combined use of peripheral parenteral nutrition and enteral nutrition. In the combined method, half the calculated total nutritional requirements was provided via the peripheral venous route, and the remaining amount via the enteral route. The three nutritionally supported groups of patients were compared with patients who received the usually administered conventional fluid therapy, where insufficient amounts of calories and no protein were provided

Single stage repair of hypospedias by mustrade technique: experience in

Thirty patients having distal and mid penile hypo-spedias with chordee were operated upon during the period from January 1993 to May 1998 in Al Zahraa University hospital. Their ages ranged between 3 and 24 years. Mustarde technique was used in construction of the new urethra. This technique proved its efficacy in the repair of distal and mid penile hypospedias with chordee as a single stage repair without obvious complications