[Surgical treatment of stress ulcer]

Results are reported of the operative treatment of stress ulcers by a refined method of selective proximal vagotomy (SPV), selective vagotomy (SV) with distal resection (DR) completely preserving the blood supply to the stomach along the minor curvature. For the period 1981-1988 a total of 82 patients with severe hemorrhage from stress ulcers have been treated. Thirty two of them were operated. In 2 patients SPV was performed by a modification suggested by the author and in another 6--SV also by modified technique with antrectomy B I. All patients recovered, none of them died. The results were compared with those in classical resection (17 operations, 1 reoperation, 12 repeated hemorrhagic episodes, 14 lethal cases) and with ulcer suturing (7 operations, 2 reoperations, 2 repeated hemorrhagic episodes, 7 lethal cases). The methods of SPV and SV with DR are recommended by the author as methods of choice, as they are pathogenetically grounded: satisfactory anacidity is achieved and the perfusion capacity of the stomach is preserved.