Randomized trial of truncal vagotomy with either pyloroplasty or pyloric dilatation in the surgical management of chronic duodenal ulcer.

A randomized trial of 41 patients undergoing truncal vagotomy with pyloroplasty (TV + P) or truncal vagotomy with graded pyloric dilatation (TV + PD) for chronic duodenal ulcer is reported after mean follow-up of 34 months. There was no evidence of gastric stasis in patients who did not have a pyloroplasty. Liquid gastric emptying studies showed an increased rate of gastric emptying postoperatively in patients both with and without pyloroplasty. Overall clinical gradings at review were similar in both groups although there were more patients who were completely symptom free in the group with pyloric dilatation accompanying vagotomy.