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Abstract
Chronic duodenal ulcer disease is a common disease nowadays and although benign, it causes a high rate of mortality which equals that of some dangerous diseases such as pancreatic and esophageal carcinomas. So there is a continuous need for a successful treatment for this disease. Many types of treatment either surgical or medical were devised in this way and they vary in either giving high curing rates but with high mortality and complications rates, or giving low mortality and complications rates but with low curing and high recurrence rates. Our study, which included 20 patients with chronic DU, ASPTV alone was applied to 10 of them and ASPTV assessed by intraoperative ECRT was applied to the other 10 patients, revealed that laparoscopic anterior seromyotomy with posterior truncal vagotomy, which was first introduced by Taylor with open surgery and by Mouiel et al. with laparoscopic surgery, particularly when assessed by intra-operative endoscopic Congo red test, is overall a very safe, patient compliant. It has overall good recovery rates in terms of control of duodenal ulcer. It is technically easy and can be done in a short time. It has a minimum post-operative morbidity and preserves near normal stomach when compared with other procedures for duodenal ulcer. After two years follow-up we had no recurrent cases and no cases of ischemic necrosis oflesser curvature were encountered. Also, we found that the intra-operative endoscopic Congo red test was very beneficial in the intra-operative assessment, so we recommend it as an essential step of laparoscopic ASPTV.