The physiopathologic background and standard technique of selective proximal vagotomy and pyloroplasty.

The observations collected on selective proximal vagotomy plus functionally and structurally appropriate pyloroplasty during a period of 13 years have demonstrated that inadequate selective proximal vagotomy results in an excessive rate of relapses and that adequate selective proximal vagotomy without drainage leads to stasis, resulting in retention difficulites or secondary gastric ulcers. In both instances, reoperations are to be expected. If complete healing without resection is what one wishes to accomplish, and who doesn't, adequate selective proximal vagotomy combined with structurally and functionally appropriate pyloroplasty is indicated. This combination can now be considered a reliable standardized procedure of curative nonresection surgical therapy for gastroduodenal ulcers.