Highly selective vagotomy in the treatment of duodenal ulcer in a teaching hospital. A one-to-three year follow-up relating results to the number of operating surgeons, their surgical experience, and training conditions.

In the present series, highly selective vagotomy (HSV) was used in the treatment of duodenal ulcer and the patients were followed up 1 to 3 years after operation. Three months after operation, 57% of the patients had positive insulin tests (early and late positive). Ulcer recurrence rate was approximately 6.5%, whereas 18% of the results were judged to be therapeutic failures. The operations were done during the period of introduction of the method in a general surgical department of a teaching hospital, when the enthusiasm was great and the experience of the individual surgeon with HSV was small. The moderately poor results in this series are thought to be due to too many surgeons operating on a rather limited number of patients. Unrelated to this situation, a statistically significant increase in the frequency of positive insulin tests during the observation period was found, giving an incidence of 80% positive tests 2 years after the operation.