Posterior Truncal Vagotomy and Anterior Highly Selective Vagotomy.

Peptic ulcer disease continues to be a major health care problem in the United States. Fortunately, the overall majority of patients can be expected to heal their ulcers with aggressive medical treatment. Nonetheless, a small but discrete group of patients will require surgical treatment for their disease. A minimally invasive approach to the treatment of peptic disease offers numerous advantages to patients including, early discharge from the hospital, early return to normal activity, and minimal postoperative discomfort. Numerous options are available to the surgeon for the treatment of patients presenting with peptic ulcer disease. One of these, posterior truncal vagotomy combined with anterior highly selective vagotomy, seems to provide definitive treatment of chronic duodenal ulcer disease.