Long-term results of vagotomy in the light of endoscopy

In the period 1968 to 1973, 177 patients were vagotomized. Endoscopy had to be performed because of definite symptoms in 37 of these patients on 56 occasions between 1971 and 1979. Vagotomy had been selective in 22, truncal in 15 cases. The intervention, regardless of its type, had failed to give the expected benefit in 21% of the patients, a proportion not inferior to the postresection figures. On the other hand, in 12% it was a recurrence of the ulcer which accounted for the symptoms. This is greatly in excess of the recurrences recorded after gastric resection either of the Billroth I or the Billroth II type. This has been attributed to inadequate technique, unsuitable indication or inappropriate selection of the type of surgery.