The problems of recurrent gastro-jejunal ulcer

Recurrent gastro-jejunal (stomal, anastomotic) ulcer after extensive Billroth II re-resection with or without vagotomy, is an uncommon but serious and difficult problem. Two illustrative cases are presented. Following a transthoracic vagotomy both patients remained symptom-free after 18 months and 3 years respectively. Transthoracic vagotomy performed as the sole procedure in selected cases of this type, offers definite advantages such as technical ease, low morbidity and mortality, and freedom from the sequelae of a minimal gastric remnant or a total gastrectomy.