[Indications, incidence of recurrence and late results after selective vagotomy]

At the Clinic and Polyclinic for General Surgery of the Westfälische Wilhelms Universität Münster a total of 125 patients were vagotomised because of chronic duodenal ulcers during the period from 1. 1. 1973-31. 12. 1988. The case histories were analysed retrospectively. Standardised questionnaires were sent to the patients in order to gain more information about the post-operative progress and about possible complications after vagotomy had been carried out. 12.2% of the patients questioned developed a recidive ulcer 1-16 years after the operation which resulted in 8 cases in a Billroth II gastrectomy with Y-anastomosis according to Roux. 7 of the 9 recidives occurred during the first two post-operative years. The average time before relapse occurred amounts to 1.7 years in spite of drug treatment. As the initial operation was performed more than 6 years ago in 88.1% of the patients and in this respect later occurring recidives could have been detected, it is to be assumed, that relapses manifest themselves, if at all, relatively soon after the initial operation. The surgical therapy of the recidive ulcer by means of B II gastrectomy was associated with a favourable prognosis; all patients were able to resume work. A comparative analysis of the later results in 67 patients of various age structures showed that with increasing age the rate of patients who considered the operation as successful decreased. Of those up to 25 years 66.7% considered themselves as recovered, of those between 41-45 years 22.2%. It can be concluded that a selective proximal vagotomy represents a curative method in the case of chronic relapsing uncomplicated duodenal ulcers. Satisfactory results could be obtained especially in young patients who develop temporary stress ulcers. Good long-term results can be obtained here, despite the high relapse rates described in our own collective of patients as well as in literature.