Treatment of gastric ulcer by parietal cell vagotomy and excision of the ulcer. Rationale and early results.

Twenty-two patients with gastric ulcers located at the incisura angularis underwent parietal cell vagotomy without drainage and an intraluminal excision of the ulcer through a small gastrotomy on the greater curvature. These patients were followed up for two to five years. Results were excellent to good in 87% and fair in 5%; 9% of the procedures were failures. One failure was due to recurrent ulcer, possibly related to ingestion of a dopamine antagonist. A second failure was due to the development of adenocarcinoma of the stomach three years after the original surgery. The etiology of gastric ulcers is unknown. If there is validity to the hypothesis that peptic acid ulceration occurs in gastric mucosa damaged by reflux of duodenal contents, then there is a physiologic basis for the operation. The good results obtained in our patients are consistent with the results reported by others.