[Functional gastric surgery (author's transl)]

Twenty years of intensive clinical and experimental research have resulted in the successful development of a modern model of gastric secretory and motility physiology as a basis for further differentiating work in this field. Conventional gastric resection as principal method in the treatment of benign hypersecretory gastroduodenal ulcers seems to be superseded by selective proximal vagotomy with pyloroplasty on the basis of excellent results with this procedure. Selective proximal vagotomy can be carried out in place of the standard Billroth resection procedure in 80% of cases. However, the attainment of technical perfection by a few skilled specialist surgeons at selected centres and the precise evaluation of gastric secretion data both pre- and postoperatively are prerequisites for a successful outcome.