Surgery for gastric ulcer

Despite the initial healing achieved by medical treatment with carbenoxolone, surgery is frequently needed in the management of gastric ulcer. We have studied 150 patients over the past 10 years in an attempt to define the place of conservative surgery compared with the standard partial gastrectomy of the Billroth I type. Functional results have not been significantly different and the individual surgeon's choice will depend on his philosophy with regard to the risk of cancer in the postoperative stomach, and his technical expertise with the newer kinds of vagotomy. To my mind it is perfectly justifiable to use highly selective vagotomy with excision of the ulcer to treat gastric ulcer alone, especially if the patient is one in whom postgastrectomy symptoms could be disabling. Further follow-up is needed to decide whether it should replace partial gastrectomy as the standard procedure.