Surgery is preferable in patients with severe chronic peptic ulcer disease

Conservative treatment given as interrupted courses is easy and successful for the majority of patients with peptic ulcer disease. For those plagued for years and years by severe chronic complaints the choice will be maintenance treatment or surgery. Maintenance treatment possibly spares the patient for an operation but includes a risk of stenosis claiming the necessity of a drainage operation with risk of sequels. The taking of the pill means a daily remembrance of the disease. Relapse rate is high. The economic problem is not unimportant for the patient. When contra indications are taken seriously into consideration modern ulcer surgery is not dangerous. There are no sequels if the pyloric function can be left intact. The cured patients feel fit and will usually forget the disease. Recurrence rate is lower than that during maintenance therapy but if occurring early they may be difficult to treat. The young patient with severe chronic duodenal ulcer disease should not wait eternally for a parietal cell vagotomy. When the ulcer is located to the pyloric channel prolonged conservative treatment may be advisable. Treatment policy for the gastric ulcer is debatable. No treatment is yet ideal. The advice to the individual patient should be based upon a non-prejudiced evaluation of the advantages and disadvantages of the therapeutic possibilities necessitating that the gastroenterologist and the surgeon have a thorough knowledge of the results of the other speciality.