Results of five standard operations for elective surgery of duodenal ulcer

459 patients who were operated on electively for duodenal ulcer in the Surgical Department, University of Turku, in 1965-1976 are reviewed. The operations were: Billroth II resection (B II) 95, truncal vagotomy and antral resection (TV-A) 61, selective gastric vagotomy and antral resection (SV-A) 159, vagotomy and pyloroplasty (V-P) 70, and parietal cell vagotomy (PCV) 110 patients. Operative mortality was 0 in B II, 4.9% in TV-A, 0.6% in SV-A, 1.4% in V-P, and 0 in PCV. About 80% of patients were interviewed 3-12 (mean 5-7) years after operation. Dumping, diarrhea and vomiting occurred less frequently after PCV, but dyspepsia was as common as after B II, TV-A, SV-A, or V-P. Recurrence rates were: after B II 2.7%, TV-A 0, SV-A 0.7%, V-P 9.7% and PCV 8.5%. The incidence of good overall results (Visick grades I + II) was similar after PCV and B II (70% and 69%) which was significantly better than after V-P (41%) and compared favorably with TV-A or SV-A (56% and 54%).