Highly selective vagotomy with excision of the ulcer compared with gastrectomy for gastric ulcer in a randomized trial.

Fifty-six patients with benign gastric ulcer of the body of the stomach have been entered into a randomized trial of highly selective vagotomy with excision of the ulcer (HSVE) (26 cases) against standard Billroth I partial gastrectomy (BI) (30 cases). The operations were carried out by all grades of surgical staff. No patient died within 1 month of operation. Postoperative morbidity was greater after gastrectomy than after HSVE. At an average follow-up of about 4 years, functional results according to a modified Visick classification were similar in both groups, with about 75 per cent good results. Two recurrent ulcers occurred after gastrectomy (7 per cent) and 4 after HSVE (15 per cent). Neither operation has a distinct advantage at this stage.