Five to Nine Years' Results of Selective Proximal Vagotomy with and Without Pyloroplasty for Duodenal Ulcer

In a retrospective study the clinical and secretory results of 118 patients operated upon with selective proximal vagotomy (SPV) with or without pyloroplasty for duodenal ulcer were examined. The results of surgery in the two groups, with pyloroplasty or without pyloroplasty, were compared. The recurrence rate was higher, although statistically not significant, for patients operated upon without pyloroplasty (19.2%) than for patients operated upon with pyloroplasty (10.6%). Dumping was significantly more common and more severe after SPV with pyloroplasty than after SPV without pyloroplasty. The acid response to histalog stimulation at follow-up was significantly higher for patients operated upon without pyloroplasty. This study indicates that SPV without pyloroplasty results in less dumping but gives a poorer protection against recurrent ulceration than does SPV with pyloroplasty. Further long-term studies appear to be necessary, however.