Gastrectomy for recurrent ulcer after vagotomy: five- to nineteen-year follow-up.

Sixty patients with recurrent ulcers after vagotomy were treated by partial gastrectomy without revagotomy. One patient died after surgery. Seven others died of unrelated causes and one patient was lost to follow-up before 5 years, without rerecurrence having been diagnosed. Of the remaining 51 patients, one underwent reoperation for rerecurrent ulcer and four for postgastrectomy symptoms before 5 years of follow-up. Forty-six others were followed for between 5 and 19 years, in addition to the one postoperative death. Major postoperative complications occurred in four other patients. Recurrent ulceration developed in four of 51 patients. The patients were classified according to a modified Visick system with regard to recurrent ulceration and postgastrectomy symptoms: Visick I, 16 patients; Visick II, 14 patients; Visick III, 11 patients; and Visick IV, 11 patients. Gastrectomy after vagotomy can be achieved with a low mortality and recurrent ulcer rate but with a high incidence of postgastrectomy symptoms.