Massive gastrointestinal hemorrhage: a twenty-five year experience with vagotomy and drainage.

Old age and massive hemorrhage long have been recognized as ominous prognostic signs in the management of patients with peptic ulcer disease. The authors present the results of their long-term evaluation of 73 such patients. The group was unselected, critically ill, and treated surgically for the arrest of profuse hemorrhage. Accurate follow-up was achieved for 100 percent of the group; this follow-up spanned periods extending to 25 years. In comparison to published reports of similar high risk groups treated with resectional therapy, the vagotomy and pyloroplasty is shown to be comparable in long-term results and vastly superior in terms of operative mortality rate. The mortality rate for the advocated procedure was 8 percent, with a proven recurrence rate of 3.1 percent.