[Parietal cell vagotomy (PCV): the treatment of choice of duodenal ulcer].

Gastric resection or vagotomy plus drainage are not easy alternatives for the treatment of duodenal ulcer. More complications are met after resection, more relapses after vagotomy, whereas the postoperative sequelae are the same for both operations. Vagotomy of the parietal cells is designed to prevent all such sequelae by leaving the innervation of the antrum intact so that drainage can be omitted. Experience has so far shown that very few complications occur, whereas severe and slight dumping and diarrhoea are virtually eliminated. Gastric emptying times are slightly affected (a little longer for solids and a little quicker for fluids), but drainage in non-stenosing cases of duodenal ulcer is not necessary. The true average incidence of recurrences after this operation cannot yet be determined, since the results of the published series vary considerably. This may be due to the continuous progress being made in the development of the surgical technique. Random studies comparing this operation with other forms of duodenal management are urgently required. It is, of course, essential for surgeons practising the new operation must, as in the case of other delicate surgial procedures, to receive a proper training at specialised centres.