[Proximal gastric vagotomy]

The incidence of uncomplicated peptic ulcer disease has markedly decreased all around the world over the last two decades. The medical and surgical management of patients with peptic ulcer disease, has also changed with the use of more effective drugs. Currently, the objectives of ulcer surgery are to eradicate the disease, to leave the gastrointestinal digestive apparatus as normal as possible, and to achieve these goals with the lowest possible mortality and recurrence rates. Proximal gastric vagotomy is currently the procedure of choice for a large number of gastric surgeons in the treatment of patients with chronic duodenal ulcer, who have failed medical therapy. Its application in treating the complications of peptic ulcer disease, which represent the greater percentage of all operations done for peptic ulcer disease, is less well-tested. However, initial series report good results in selected patients. Proximal gastric vagotomy without a drainage procedure, is the latest contribution to ulcer surgery. The operative mortality, is nearly zero, the recurrence rate of 4% to 11%, and there is virtual absence of significant side effects.