[Individual selection for operation in the surgery of ulcer]

In 918 operations of gastroduodenal ulcer the operation was individually chosen. The critically indicated selective oral vagotomy with or without drainage operation yielded comparatively good results, it is a valuable supplementation of the previously only performed resection treatment. Ulcus duodenum and ulcus pepticum jejuni post-operativum are the domain of vagotomy, whereas in ulcus ventriculi in most cases is resected according to Billroth I. In old patients or severe concomitant diseases vagotomies--even in hypochlorhydria--yield as satisfying results as excision of ulcer and segment resections. Bleeding or perforated parapyloric ulcers were in selected cases also treated by vagotomies. On account of good early and late results the 2/3 resektion after Billroth I or II is never defective and it is more favourable for the patient than a wrongly indicated and technically insufficiency performed vagotomy. Operative techniques should be used which are mastered methodically. The vagotomy demands a critical indication and cautions technique, in the hand of an experienced operator it anticipates the removal of peptic ulcer. A final judgment is allowed only after an interval of 1 to 2 decenniums.