The place of transthoracic vagotomy in the management of recurrent peptic ulceration.

For the successful treatment of recurrent peptic ulceration confirmation of the presence of the ulcer by fibreoptic endoscopy is essential. Further investigation by barium meal and gastric acid secretion studies allows a rational surgical approach to be formulated. This process is illustrated by discussion of the investigative findings and the results of treatment in a series of 20 patients with recurrent peptic ulcer over a 5-year period. In one-half of these patients a second abdominal operation was necessary, but in the other half a transthoracic vagotomy alone gave equally good results.