[Selective proximal vagotomy with ulcer excision or Billroth I resection in chronic stomach ulcer. A prospective...

In a prospective randomised multicenter study in 41 patients with chronic gastric ulcer type I according to Johnston we compared selective proximal vagotomy (SPV) plus ulcerectomy (21 patients) with a standardised Billroth I gastrectomy (20 patients). The follow-up period was at least 2 years. Preoperative characteristics of both groups did not differ. Intraoperatively, in 5 patients of the SPV group technical problems during dissection of the lesser curvature occurred. The main postoperative complaints were pain and epigastric fullness after SPV and bile vomiting, early dumping or diarrhea after Billroth I gastrectomy. 3 of 21 patients after SPV developed recurrent ulceration, whereas after BI resection no recurrence was observed. This study indicates a higher recurrence rate in gastric ulcer patients after SPV compared to Billroth I gastrectomy.