Surgical Treatment of Recurrent Peptic Ulcer Disease

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Abstract
A total of 120 patients in whom recurrent peptic ulcer developed after various surgical procedures for primary duodenal ulcer were operated on between 1970-1975. The postoperative mortality rate was 3.3% for all cases, 0.9% for elective cases and 23% for the 13 patients who required emergency surgical care. The mean hospital stay was 13 days and postoperative complications developed in 25 patients (20%). Approximately 70% of the patients had excellent or good results, whereas the rest had significant postoperative sequelae, including 8.4% (9 patients) in whom rerecurrent ulceration developed. When remedial surgery for recurrent ulcer consisted of vagotomy and distal subtotal gastrectomy (35 patients) after previous vagotomy and drainage procedure (21 patients), subtotal gastrectomy (3 patients), vagotomy and hemigastrectomy (8 patients) or gastroenterostomy alone (3 patients), there were no operative deaths, 74% of 27 patients available for at least a 5 yr follow-up had excellent or good results and rerecurrent ulceration developed in only 1 patient. Vagotomy and resection is a satisfactory operation for recurrent peptic ulcer and the long-term results after this operation compared favorably with those reported for cimetidine therapy.