Perforated duodenal ulcer managed by simple closure versus closure and proximal gastric vagotomy.

A prospective randomized trial of simple closure versus closure and proximal gastric vagotomy was conducted in 50 consecutive patients with perforated duodenal ulcer. There was one postoperative death in each group and no difference in postoperative morbidity. After a median follow-up of 54 months (24-96) the cumulative recurrence rate after simple suture was 52 per cent against 16 per cent after proximal gastric vagotomy and closure (P less than 0.01). The recurrence rate after proximal gastric vagotomy for perforated duodenal ulcer was comparable to the recurrence rate seen after the electively performed operation.