Surgical treatment of duodenal ulcers. When? How? Why?

This report describes a personal experience of 2472 operations carried out for duodenal ulcers between 1964 and 1982 in Athens, Greece. An attempt is made to assess the short- and long-term results after different surgical approaches including truncal vagotomy and antrectomy, truncal vagotomy plus drainage (pyloroplasty or gastrojejunostomy), polya gastrectomy, and proximal gastric vagotomy. All the above procedures were used in dealing with this series of patients. Through a selection process by use of clinical and operative criteria for each individual case, each procedure was carried out to fit the individual demands of each patient. From the above policy our results were satisfactory. We had an overall mortality rate of 0.58 per cent with a late reoperation rate of 4 per cent which included patients with recurrent peptic ulcers, the dumping syndrome, and alkaline reflux gastritis.