Critical Appraisal of Vagotomy and Pyloroplasty

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Abstract
The reintroduction of pyloroplasty and the combination of this procedure with vagus nerve section have provided a relatively simple but physiologic approach to the surgical treatment of duodenal ulcer. Although widely accepted on a physiologic basis, the exact role of this procedure in the surgical treatment of duodenal ulcer remains unclear to many clinicians. The present study is a critical appraisal of the results and complications of this operation performed on 500 patients, 317 of whom were followed up two to eight years. The ulcer diathesis was controlled in 84% of the patients; 13% of the patients required medication for occasional but regularly occurring symptoms and 3% had results classified as poor. The surgical mortality for the entire group was 4.2%. The surgical mortality in 50 patients operated on as emergencies during the period of uncontrolled and massive hemorrhage was 24%. In contrast, there was no operative mortality in 36