Recurrent duodenal ulcer.

In the past 6 years 26 patients underwent operation for recurrent duodenal ulcer after what was considered to be an "adequate" initial operation. In such patients it is necessary first to demonstrate the recurrent ulcer and then to determine its cause. Endoscopy was the best means of confirming the diagnosis. The cause of recurrence was determined by tests for gastric acid secretion; 70% of patients had hyperacidity and 80% had positive results of the Hollander test. Treatment is always surgical but varies depending on the type of initial surgery, the primary cause of recurrence and the condition of the patient. Ten patients underwent vagotomy, 12 had vagotomy with antrectomy and 4 had antrectomy alone. There were no operative deaths but nine (35%) patients experienced 11 significant postoperative complications.