Surgery for duodenal ulcer. A study relating indications to the results of surgery

The present study correlates the indications for operation in 215 patients with duodenal ulcer disease with the results of operative management. The majority of patients had conservative surgery utilizing truncal vagotomy and pyloroplasty or gastrojejunostomy. None of the 194 patients operated on electively died and four patients died after emergency operations, for an overall operative mortality in the entire series of 1.8 per cent. The incidence of recurrent ulcer symptoms in all patients was 10 per cent. We could demonstrate only a modest correlation between indications for operation and long-term results of conservative surgical management; the indication for surgery, whether that of chronic (intractability, stenosis) or more acute (hemorrhage, perforation) ulcer disease is only moderately reliable as a predictor of long-term results. In this series of patients, those with obstructing duodenal ulcers (pyloric stenosis) had the best long-term results after conservative surgical management.