Causes and clinical aspects of postoperative recurrent peptic ulcer

General practitioners as well as surgeons should be aware that there is a high recurrence rate after the "standard" operation (vagotomy and pyloroplasty) for duodenal ulcer. Recognition of recurrence is much delayed. The much lower recurrence rate, with similar morbidity and mortality rates, after vagotomy and antrectomy, make this the operation of choice at present. The high overall recurrence rate, the not inconsiderable operative morbidity and occasional mortality, and the high postoperative morbidity rate for peptic ulcer surgery indicate that such surgery is not to be undertaken without positive indications, such as the presence of complications. An operation undertaken solely because an ulcer recurs within, say, two years can no longer be justified.