A follow-up study of 108 patients 2-8 years after precise antrectomy for gastric ulcer showed no ulcer recurrences. The frequency of complications was similar to that following conventional resections. Biopsies taken at gastroscopy at the time of follow-up showed permanent removal of all functioning antral mucosa; no gastrin-producing cells could be recovered from any part of the gastric remnant. There was a close relationship between gastric acid secretion and the incidence and spreading of chronic atrophic gastritis in both resected specimens and biopsies. Following precise antrectomy alone, acid secretion was reduced considerably 3 months postoperatively, and the reduction was unchanged at the time of follow-up. In patients with a high preoperative insulin-stimulated acid secretion, precise antrectomy plus vagotomy reduced acid secretion significantly more than precise antrectomy alone. Besides producing a decrease in acid secretion, the advantage of precise antrectomy appears to be that the target area for recurrent gastric ulcer is permanently removed.
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