tolito wrote:vagotomy and gastric resection no longer gold standard rx for PUD. now give PPI + clarithromycin + amoxycillin. (KAPLAN) Hey, this tiple regimen is different from the one we learnt in step 1 ala lippincott  this is supposed to be second line after bismuth + tetra + amoxy. CAN ANYONE PLEASE VALIDATE THIS?
Vagotomy and gastric resection is never the gold standard despite my Professor graduated from John Hopkins and was trained in those procedures. He was in his retirement age and I have only seen him done a few cases for intractable PUD with massive bleeding that required surgery and it was the time before PPI introduced !
Just a piece of history of medicine (DO not shot the messenger !)
Now you understand your book may be out of date !
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| tolito
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AAAAA, thanks for going down the memory lane with me. you have second hand info but i have first hand. i was there when we compared the results of the Bilroth procedures and then vagotomy and then selective vagotomy and then highly selective vagotomy with the H2 antag which were very new drugs. first came cimetidine which we later dumped for ranitidine. teh PPI came after i was done with post graduate training. they were only speculations and experimental when i was in school. H PYLORI was not even discovered, the stomach was sterile back in the days. you wont see your prof perform these procedures cos you came after the revolution. ( no offense meant )
i do appreciate all your inputs. please be patient with me cos i need to 'unlearn' stuff i knew. i am reading the 2005/2006 kaplan and a lot of the old stuffs are mentioned only to discard them. this is good for oldies like me.
thanks all
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