Prevention of ulcer recurrence--medical vs surgical treatment. The surgeon's view

The need for surgical intervention in duodenal ulcer disease will undoubtedly decrease in the years to come. Occasional failure of medical treatment and persistent doubts about the long-term safety of anti-ulcer drugs will continue to make operation the treatment of choice for some patients, however. Long-term medical treatment and surgery can be considered equally acceptable options for most patients. When operation is considered necessary, parietal cell vagotomy fits the requirements of a modern surgical method better than other techniques. The effective medical treatment now available makes postoperative recurrence of ulcer less important than before and lack of postoperative symptoms has replaced fear of recurrent ulceration as the main concern in the value judgement of both doctors and patients.