Influence of different techniques of proximal gastric vagotomy upon risk of recurrent duodenal ulcer and gastric acid secretion.

ABSTRACT

Different techniques of proximal gastric vagotomy were used from 1970 to 75 in 267 patients with duodenal ulcer. A 1-4 years clinical follow-up showed an unacceptable high rate of recurrent ulcer (23-24%) in patients having skeletonization of the lower 2 cm of the esophagus, regardless of the extent of preserved antral innervation (6-9 cm). Extension of the esophageal dissection resulted in a lower recurrence rate (8%) and a higher frequency of complete vagotomies as expressed by the average acid response to insulin. No constant relationships were found between reductions of basal acid output and peak acid output to histamine 10 days after proximal gastric vagotomy and the risk of recurrent ulcer.