[Initial interventions in ulcer disease: indications--choice of procedure--results]

Routine use of H2 receptor blockers in the therapy of chronic gastroduodenal ulcers reduced the number of ulcer operations. The ulcer recurrence rate in postpyloric and duodenal ulcer seems to be lower after highly selective vagotomies than during long term maintenance treatment, prepyloric ulcers are treated best by gastric vagotomy and antrectomy. In the absence of risk factors perforated gastroduodenal ulcers are treated better by definitive surgery (suture plus vagotomy) than by simple suture.