Ulcer recurrence two to twelve years after parietal cell vagotomy for duodenal ulcer

An analysis is presented of the ulcer recurrence rate following parietal cell vagotomy in 333 patients with duodenal ulcer. The median period of observation for patients without ulcer recurrence was 54 months (range 1 to 128 months). Forty-two patients developed proven recurrent ulcer. The median period of freedom from recurrence was 33 months (range 3 to 113 months). Recurrent ulcer was suspected but not verified in an additional 12 patients. The calculated risk (by the life table method) of recurrence after 5 years was 13% (95% confidence limits 9-17), after 8 years 21% (14-28), and after 10 years 23% (15-31). The rate of recurrence remained constant throughout the study period. The analysis indicates a constant monthly recurrence risk of 0.23%. The patients with ulcer recurrence had a significantly lower reduction of peak pentapeptide acid output and higher rate of positive insulin test than patients without recurrence. The risk of recurrence did not depend on the location of the ulcer (duodenal bulb or pyloric-prepyloric area).