Proximal gastric vagotomy without drainage for duodenal ulcer: results after 5-8 years.

Experience with proximal gastric vagotomy without drainage in the treatment of 316 men with duodenal ulcer is surveyed, with particular reference to the 117 who have been followed up for 5–8 years and whose results are compared with those obtained after other standard elective operations. There were no operative deaths. Symptoms suggestive of recurrent ulceration developed in 12·0 per cent of the entire series of 316 cases, but in only 3·8 per cent was the presence of a recurrent ulcer definitely established. In the 117 cases followed up for 5–8 years similar symptoms were noted in 15·4 per cent, but the presence of a recurrent ulcer was proved in only 4·3 per cent. At 5–8 year follow-up dumping was virtually completely absent and diarrhoea was significantly less than after truncal vagotomy with drainage or antrectomy, whilst there were insignificant reductions in the incidence of post-prandial epigastric fullness and bile vomiting. Visick grading at 5–8 years rated the result as excellent or very good in 75 per cent of the cases, as fair in 13 per cent and as a failure in another 12 per cent. The advantages and disadvantages of proximal gastric vagotomy without drainage relative to those of truncal vagotomy with drainage or antrectomy are discussed.