VAGOTOMY with pyloroplasty has markedly altered our attitude toward duodenal ulcer disease. This highly effective operation with its minimal mortality and morbidity permits new leniency in the criteria for operative intervention. Patients, surgeons, and referring physicians no longer need express reluctance relative to the harsh experience of subtotal gastrectomy.
Yet greater benefits would accrue if a parallel alteration in criteria and attitude were permitted in the care of patients with gastric ulcer disease; for the results of conservative therapy in these patients is infrequently rewarded by permanent control of the diathesis, and occult carcinoma remains an additional significant factor. Furthermore, the gastric ulcer patient is frequently elderly and infirm—adverse factors of great surgical import. Vagotomy and pyloroplasty will be welcomed by all if proved effective in gastric ulcer control.
Fifty-five patients have undergone pyloroplasty with or without vagotomy for "benign" gastric ulcers (Table 1). Ulcerating lesions suspect for carcinoma