Surgical treatment of duodenal ulcer: a prospective randomized study

From 1960 to 1980, 344 patients were included in a prospective randomized study for elective surgical treatment of duodenal ulcer disease. Results of vagotomy and pyloroplasty were compared with vagotomy and hemigastrectomy. There were no postoperative deaths, the postoperative complication rates were similar for both groups. Ulcerations recurred in 12% of the vagotomy-pyloroplasty group and in 3% of the vagotomy-hemigastrectomy group (P less than .05). Independent analyses of recurrence were performed for young patients, for alcoholics, and for patients who had obstructions or were bleeding preoperatively. Recurrence rates in these special populations were not found to be significantly different. Eight percent of the vagotomy-pyloroplasty group required reoperations for recurrent ulceration; only 2% of the vagotomy-hemigastrectomy group required reoperation. Postoperative dumping symptoms were significantly more frequent in the vagotomy hemigastrectomy group. Postoperative diarrhea was also more frequent and more severe in the vagotomy-hemigastrectomy group.