Prospective evaluation of selection for operation for duodenal ulcer based on acid secretory studies: Interim report after 1-5-year follow-up.

The interim results of elective vagotomy for duodenal ulcer in 102 patients in whom the pre-operative pentagastrin-stimulated maximal acid output (MAO) was used to select patients for operation have been propectively evaluated 1-5 years after operation. Sixty-seven patients had an MAO of less than 25 mmol/h and were submitted to truncal vagotomy with a drainage procedure; 35 had an MAO in excess of this and underwent antrectomy in addition to truncal vagotomy. There have been no deaths and no proven recurrences of duodenal ulcer. Two patients in the truncal vagotomy and drainage group have developed gastric ulcers, probably due to gastric stasis, and are the only patients in the series who can be classified as surgical failures (Visick grade 4). The preliminary results indicate that the selective policy is justified.