[Evaluating elective surgical procedures in ulcer surgery].

Elective surgical treatment of peptic ulcers is less important after the introduction of effective conservative treatment. However, in a chronic recurrent disease all options of treatment have a place. In duodenal ulcer highly selective vagotomy is the procedure of choice despite the high recurrence rate, since it has a low operative risk and a low rate of early postoperative morbidity or late sequelae. In gastric ulcer distal partial gastrectomy (Billroth I) must be recommended using the same criteria. Laparoscopic techniques will not alter the indication for surgery; these procedures are still hampered by technical problems and the main problem of high recurrence rate after vagotomy is not solved by choosing a different approach to the abdomen. Surgical treatment of peptic ulcers must be revalidated in respect to health care reform.