The surgical treatment of peptic ulcer comparing vagotomy and gastric resection

1. Forty-nine patients who had vagotomy and 33 who had gastric resection, which constitute all of the cases since the opening of this hospital, have been reviewed and compared. 2. There have been no hospital deaths in either series with the exception of one case moribund from acute hemorrhage, who was explored only as a last resort. 3. Surprisingly enough, the number and severity of complications have been higher following vagotomy than following gastrectomy. 4. Results thus far are somewhat in favor of vagotomy with drainage over subtotal gastrectomy. The apparent advantage of vagotomy over gastrectomy will be further enhanced when we consider the following three factors: a. Although in our small series there has been no mortality following either procedure in elective cases, the literature shows a definitely greater number of fatalities following gastrectomy than following vagotomy. b. The great majority of patients who have undergone gastrectomy remain gastric cripples, whereas the only limitation in diet, tobacco and alcohol imposed upon our postvagotomy patient has been "everything in moderation." c. In this particular comparative study, 50 per cent of the gastrectomy series were for gastric ulcer which are notorious for their favorable response to any type of surgery.