Proximal selective vagotomy without pyloroplasty. A randomized clinical study.

50 consecutive male patients with a proven duodenal ulcer disease without pyloric stenosis were electively treated with a proximal selective vagotomy. They were randomized in a group with and a group without pyloroplast. Up to now (1-3 years follow-up) no recurrences were found, and only two patients have major complaints (Visich grading 3). There are no differences between the two groups, as judged by the clinical result, the pentagastrin test, the Hollander test (2-DODG stimulation), and the gastrin analysis. Pyloroplasty therefore is not needed. Although the vagotomy which completely preserves antral motility is mostly incomplete in the Hollander test, it is sufficient as judged by the clinical results and the acid response.