Truncal vagotomy and pyloroplasty for non-complicated duodenal ulcer: results 22-26 years after surgery.

OBJECTIVE

To assess the long-term results of truncal vagotomy and pyloroplasty in patients with non-complicated duodenal ulcer.

METHODS

Between 1969 and 1973, 210 patients underwent surgery for non-complicated duodenal ulcer. Of these, 92 were followed up for 22-26 years. In 67 the assessment was conducted at the outpatient consultation and in 25, by phone.

RESULTS

In 57% of patients the results were good or very good. Postpandrial fullness, heartburn and diarrhea were reported by 59, 52 and 42% of patients, respectively. Ulcerative recurrence affected 18% of patients. Although the relapsing rate was smaller in women as compared to men (7% versus 20%), physical condition and quality of life after surgery in the latter group were much worse. Thirty-five patients (38%) underwent reoperation. The distribution of patients according to the modified Visick classification after all the reoperations was as follows: I = 22 patients; II = 30 patients; III = 23 patients and IV = 17 patients.

CONCLUSIONS

Long-term results after surgery for duodenal ulcer were not very encouraging, so we suggest for these patients a medical treatment and just in exceptional cases of refractory ulcers we would recommend a surgical procedure with minimal long-term complications.