A clinical appraisal of the treatment of chronic duodenal ulcer by vagotomy and gastric drainage operation

The relationship between the severity of duodenal ulceration and the results of bilateral vagotomy and gastrojejunostomy

“…Bruce, Card, Marks, and Sircus (1959), Gillespie and Kay (1961), and Orr (1962) are advocates of selective surgery in the treatment of chronic duodenal ulcer, and there is no doubt that the ultimate aim in duodenal ulcer surgery is to find a method of selecting the corrwt Operation for each individual patient. Nevertheless, we feel the late results of the present series and of the series reported by Burge and Clark (1960), Holt and Lythgoe (1961), and Austen and Edwards (1961) show that even in unselected cases, irrespective of the severity of the ulcer, a surgeon need not fear a high incidence of stomal ulceration with the routine use of gastro-enterostomy and vagotomy for chronic duodenal ulceration.…”

“…BILATERAL vagotomy combined with a gastric drainage procedure is becoming increasingly accepted as the operation of choice in the treatment of chronic duodenal ulcer. In recent years Burge and Clark (1960), Holt and Lythgoe (1961), Austen and Edwards (1961), and Feggetter and Pringle (1963) have reported satisfactory results 10 or more years after operation. These authors found stoma1 or recurrent ulceration rates of 3.8 per cent, 1.2 per cent, 5 per cent, and 5.1 per cent respectively.…”

Histamine- and insulin-stimulated gastric acid secretion after selective and truncal vagotomy.

“…Histamine-and insulin-stimulated gastric secretion after vagotomy has been the subject of a number of papers in recent years (Weinstein, Hollander, Lauber, and Colp, 1950;Gelb, Baronofsky, and Janowitz, 1961;Kyle and Stephens, 1961;Payne and Kay, 1962;Austen and Edwards, 1961). Most workers agree that truncal vagotomy associated with a drainage procedure is followed, in the vast majority of patients by an appreciable reduction in the level of acid secretion (Gillespie, Clark, Kay, and Tankel, 1960;Gelb et al, 1961;Bell, 1964).…”

Late results of antrectomy and vagotomy.

“…Vagotomy was performed through an upper abdominal midline incision as described by Austen and Edwards (1961). The antrum was removed by a one-third to onehalf gastrectomy.…”