Surgical treatment of duodenal ulcer: a prospective randomized study
M. Mulholland, C. Morrow, D. H. Dunn, M. L. Schwartz and E. W. Humphrey
From 1960 to 1980, 344 patients were included in a prospective randomized
study for elective surgical treatment of duodenal ulcer disease. Results of
vagotomy and pyloroplasty were compared with vagotomy and hemigastrectomy.
There were no postoperative deaths, the postoperative complication rates
were similar for both groups. Ulcerations recurred in 12% of the
vagotomy-pyloroplasty group and in 3% of the vagotomy-hemigastrectomy group
(P less than .05). Independent analyses of recurrence were performed for
young patients, for alcoholics, and for patients who had obstructions or
were bleeding preoperatively. Recurrence rates in these special populations
were not found to be significantly different. Eight percent of the
vagotomy-pyloroplasty group required reoperations for recurrent ulceration;
only 2% of the vagotomy-hemigastrectomy group required reoperation.
Postoperative dumping symptoms were significantly more frequent in the
vagotomy hemigastrectomy group. Postoperative diarrhea was also more
frequent and more severe in the vagotomy-hemigastrectomy group.
