Truncal vagotomy and drainage: a comparison of elective and emergency operations

A comparison has been made between truncal vagotomy and drainage (TV + D) performed from 1968 to 1981 in 209 patients electively and in 68 patients as an emergency. The male:female distribution was 167:42 and 59:9 with a significant difference (P less than 0.001) in the mean ages of 49 years and 55 years respectively. Major postoperative complications following emergency TV + D (22 per cent) were significantly more common (P less than 0.001) than following elective TV + D (6.7 per cent) with seven (10.3 per cent) and one (0.5 per cent) deaths respectively. Of 163 patients in the elective and 54 in the emergency group followed up for an average of 5.7 and 5.9 years respectively, 132 patients (81 per cent) and 46 (82.5 per cent) had a good functional result graded as Visick I and II, but 31 (19 per cent) and 8 (14.8 per cent) patients respectively had a poor result due to recurrent ulceration in 23 (14.1 per cent) after elective TV + D and in all 8 (14.8 per cent) after emergency TV + D. These results are not statistically different. Thus emergency TV + D carries a higher mortality and morbidity than elective TV + D, but the long term results are similar. This conclusion substantiates the equivalent effectiveness of emergency and of elective TV + D.