Truncal vagotomy and resection in the treatment of duodenal ulcer

A retrospective analysis was conducted of 466 patients who underwent elective truncal vagotomy with antrectomy or hemigastrectomy for chronic duodenal ulcer. The postoperative (30-day) mortality was 1.1%. In 412 of 466 patients (88.4%), follow-up was obtained, and in 290 patients alive at the writing of this paper, the mean follow-up was 17.1 years; the remaining 54 patients (11.6%) were lost to follow-up. The overall ulcer recurrence rate was 0.7%. Severe postoperative sequelae--postvagotomy diarrhea and postgastrectomy dumping--were uncommon--0.7% and 1.0% of patients, respectively. The combination of truncal vagotomy and gastric resection is a viable alternative in the surgical treatment of chronic duodenal ulcer disease and is the authors' operation of choice for most such patients.