Choice of surgical method in treatment of chronic gastric and duodenal ulcer.

In the light of an analysis of late results of surgical treatment obtained in a group of 2450 patients with chronic gastric or duodenal ulcer subjected to various types of operations the author stresses the importance of choice of a proper surgical method. It is concluded that in treatment of chronic gastric ulcer the most appropriate method is partial gastrectomy including the whole pyloric part of the stomach. On the other hand, in chronic duodenal ulcer gastrectomy must be more extensive including over 70% of the gastric surface, it may be less extensive if associated with vagotomy. Truncal vagotomy with pyloroplasty should be applied only in high-risk patients in view of a high proportion of recurrences of peptic ulcer.