[Indications and results of surgical treatment of ulcers. Considerations after the introduction of H2-receptor antagonists].

The worldwide introduction of H2-receptor antagonists has resulted in changes in the management of gastric and duodenal ulcers. Today surgery is reserved mainly for patients with problem ulcers or ulcer complications. In this decision a lower recurrency rate of operative treatment must be weighed against higher immediate risks of this form of therapy. The treatment of choice for duodenal ulcers is the selective proximal vagotomy (SPV) without drainage, for gastric ulcers the partial gastrectomy (Billroth I- or II-procedures) or SPV, depending on their localizations. Only the differentiated use of medical and surgical treatment modalities permits optimal ulcer therapy.