Long-term results of highly selective vagotomy in the treatment of duodenal ulcer patients using the intra-operative endoscopic congo red test to identify the parietal cell antrum-corpus borderline.

A total of 151 patients with uncomplicated duodenal ulcers were treated with highly selective vagotomy. The patients were subsequently observed prospectively for a period of 3-17 years. The recurrence rate for the whole group reached 4.6%. The parietal cell antrum-corpus borderline for denervation was marked using the intra-operative endoscopic Congo Red Test. The test was useful for the classification of patients into the group (own method) and for the identification of patients with "acid antrum". Between 1974-1980, Highly selective vagotomy was performed in 93 patients in some of whom single clusters of parietal cells were diagnosed in the prepyloric region (acid antrum, type A). The recurrence rate in this group reached 7.5%. In a group of 58 patients operated on after 1980 from which "acid antrum" cases were eliminated, no recurrences have so far been observed. Additionally, the results of early and late complications and the results of patient self-estimation using to Visick's scale are discussed.