Current operations for duodenal ulcer.

The surgical treatment of duodenal ulceration of the gastrointestinal tract is reserved for specific complications of the ulcer, namely perforation, hemorrhage, obstruction of the gastric outlet, intractability, and recurrence following previous surgery. Though all persons with an ulceration share at least one symptom of the ulcer diathesis, the treatment of a specific patient's problem demands individualization so that the best-suited operative procedure will be performed. If patients are appropriately selected for surgical procedures, the success ratio is maximized, and the frequency of undesirable side effects minimized. We view the surgical procedure for duodenal ulcer not as an indication of failure of medical therapy, but as an appropriate treatment for specific complications of the disease. When indicated, curative procedures can be performed routinely with minimal chance of recurrence. Whenever an ulcer recurs, a specific plan of investigation will help differentiate incomplete vagotomy, endocrine tumors, or other common reasons for ulcer recurrence.