Clinical results 6 to 8 years after truncal vagotomy and drainage for duodenal ulcer in 500 patients.

The clinical results of truncal vagotomy and drainage for duodenal ulcer in 500 patients are evaluated by a personal 6-8 year follow up. Pyloroplasty was used unless pyloric stenosis made a gastrojejunostomy necessary. Forty-three patients had recurrence (39 were reoperated) and gastric ulcer was seen in five. The rate of dumping was 24% (severe in 3%) and rate of daily-monthly diarrhoea 40% (severe in 8%). Neither dumping nor diarrhoea was related to histamine-activated gastric acid secretion ten days after vagotomy and insulin-activated acid secretion 3 to 4 years later. Dumping was related to epigastric fullness and diarrhoea. Recurrence was related to histamine-activated secretion before and 10 days after vagotomy and to insulin-activated secretion 10 days and 3-4 days after vagotomy. Minor changes were seen in weight- and laboratory-measurements. Anemia was not related to prophylactic intake of iron. Satisfactory results (Visick I-III) were seen in 80% of the patients. The figure may be increased to 86%, including results of operations for recurrence, gastric ulcer and other diseases occurring after the original vagotomy and drainage; even then, the results seem less satisfactory than those after other operations for duodenal ulcer.