A follow-up study of patients after treatment for bleeding duodenal ulcers by selective vagotomy and drainage (4-8 years observation time).

From 1966 to 1972, 92 patients with bleeding duodenal ulcers were treated acutely by oversewing, selective gastric vagotomy and drainage. Seven patients (8%) died within the postoperative period. Subsequently 22 others have died, but from causes not associated with duodenum or stomach. One patient developed a pyloric cancer 4 years after the original operation. 53 patients could be follow-up with an observation time between 4 and 8 years. Six patients had undergone further surgery, three with duodenal ulcer recurrence six months, two years and four years, respectively, after the primary operation. One, after five years with an ulcer of the corpus of the stomach, and two others, eight months and four years, respectively, after primary operation, on suspicion of ulcer recurrence, which could not be confirmed. Three patients had severe dumping, and one, in incapacitating diarrhoea. 62% of the patients were graded in Visick group I, 19% in group II, 4% in group III and 15% in group IV. (Table III). No patient presented with recurrent bleeding, and no patient died from ulcer disease after discharge from hospital. The value of selective versus truncal vagotomy in treatment of bleeding duodenal ulcer is discussed, and it is concluded, that the procedure, which has to be performed, depends on the surgeon's experience in the vagotomy concerned.