Alle aus der traditionellen Ulkuschirurgie bekannten Operationsverfahren zur elektiven Therapie sind grundsätzlich auch laparoskopisch durchführbar. Vom pathophysiologischen Ansatz her ist die selektive proximale Vagotomie das optimale, von der technischen Durchführung her aber gleichzeitig das schwierigste Verfahren. Daher wird bisher vielfach auf die chirurgisch einfacheren Methoden der hinteren trunkulären und vorderen selektiven proximalen Vagotomie ausgewichen. Die relativ geringen Nebenwirkungen der hinteren trunkulären Vagotomie scheinen durch den Gewinn an Operationszeit, Übersichtlichkeit und Sicherheit wettgemacht zu werden, so daβ nach derzeitigem Erfahrungsstand in den Ergebnissen keine Unterschiede zu erkennen sind. Wegen der geringen Fallzahlen und der fehlenden Langzeitergebnisse kann eine sichere Bewertung der verschiedenen Vagotomievarianten zum gegenwärtigen Zeitpunkt nicht vorgenommen werden.

Keywords:
Laparoskopische Chirurgie, Vagotomie, Chronisches Duodenalulkus
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© 1995 S. Karger AG, Basel
1995
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