Long-term results of highly selective vagotomy for the treatment of duodenal ulcer.

Between 1971 and 1987, highly selective vagotomy (HSV) was carried out in 984 patients suffering from duodenal ulcer disease. In 97.3% of these cases, the surgical intervention was uncomplicated, the related mortality being 0.3%. During the follow-up period the postoperative condition of the patients was checked once a year wherever possible; in 92.3%, follow-up was continued until december 1987, the maximum period of postoperative follow-up being 16 years. No prognostically reliable indication of the risk of ulcer recurrence was obtained from an analysis of gastric juice. In 79.1% of the cases who underwent surgery, the result was good to satisfactory, while 11.7% had functional complaints such as dumping or diarrhea. The probability of developing a recurrent ulcer within 16 years after the initial operation was 29.7%. This rate of recurrence is determined among other things, by the discovery of clinically quiescent ulcers during the yearly follow-up examinations, when these are performed carefully, and over a sufficiently long period.