Surgical Treatment of Duodenal Ulcer

The position of subtotal gastrectomy as the procedure of choice for the surgical treatment of duodenal ulcer has been challenged by two maneuvers involving division of the vagus nerves: vagotomy with hemigastrectomy or antrectomy and vagotomy with pyloroplasty or gastroenterostomy. Personal experience and the reports of many workers suggest that the combination of hemigastrectomy and vagotomy produces the best over-all results in terms of operative mortality, recurrent ulceration, and distressing side effects. Evaluation of “selective gastric vagotomy” must await further studies.