Selective gastric vagotomy and drainage for duodenal ulcer: a 10-13-year follow-up study.

From 1964 to 1968 selective gastric vagotomy (SGV) and drainage was performed in 174 patients. Of these, 105 patients were followed-up 10-13 years after operation; 56 were dead. Ulcers recurred in 18 patients. The cumulated recurrence rate after 13 years (life table method) was 15% (95% confidence limits: 8-23). The method for drainage was usually either a Heineke-Mikulicz or a Finney pyloroplasty. There was a significantly higher risk of ulcer recurrence in the group that underwent Heineke-Mikulicz drainage procedures. The incidence of dumping and diarrhea had not changed during a five-year follow-up period. Two patients were slightly anemic. No patient was iron-deficient. Apart from two recurrent ulcers, gastroscopic examinations in 36 patients revealed no major changes, and biopsy specimens showed slight to moderate chronic atrophic gastritis in most cases. Visick grading showed 77% of the ulcers in Grade I + II, 19% in Grade VI. It is concluded that SGV has no place in the elective treatment of duodenal ulcer. Two alternatives are suggested.