[Gastroduodenal ulcer: surgical therapy (author's transl)]

In evaluating results after surgical therapy of gastroduodenal ulcer, lethality and recurrency rate are important criteria, but a third "quality of life" should be considered equally important. Proximal selective vagotomy seems to carry a very small lethality risk and extremely good "qualities of postoperative life." A minority of patients may need two "surgical steps" to achieve a good end result. The modified Burge test has been found useful in a prospective study. As to technical details, the denudation of the subdiaphragmatic esophagus over a distance of 5--6 cm seems paramount for achieving a good proximal vagal denervation of the acid-secreting area of the stomach.