DURING the past 25 years, the safety and efficacy of vagotomy combined with a drainage procedure have led to widespread acceptance of this procedure in the treatment of duodenal ulcer. On the basis of this experience, it is not surprising that vagotomy and pyloroplasty have been advocated for the treatment of benign gastric ulceration as well.
Although there is good experimental evidence that vagotomy decreases the humoral stimulus to the secretion of acid, other experimental evidence has shown that antral stasis will cause continued release of gastrin and stimulation of gastric secretions.1-4 Should vagotomy accentuate gastric stasis when the antrum is present, it could prove deleterious to the healing of a gastric ulcer. Clinical studies both support and reject the effectiveness of vagotomy and pyloroplasty for gastric ulcer in the absence of hypersecretion. Farris and Kraft have reported excellent results with this procedure while Woodward and Herrington have found