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Humoral Gastric Secretory Effects of Vagotomy and Distal Antrectomy

Lester R. Dragstedt II, MD; Rolando E. Creagh-Larramendi, MD; William W. Jones, MD; Louis T. Palumbo, MD
Arch Surg. 1968;97(4):575-579. doi:10.1001/archsurg.1968.01340040071012.
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THE surgical treatment of duodenal ulcer has undergone a radical change in the past 25 years since the introduction of vagotomy on Jan 18, 1943.1 Subtotal gastrectomy alone is still successfully used by many surgeons, but it seems that an increasing proportion of surgeons are now combining vagotomy with some type of drainage procedure or partial gastric resection.

It is practically impossible to compare statistics on results of surgery for duodenal ulcer from various centers. The following general conclusions have been reached by a review of the literature: Vagotomy and pyloroplasty or gastroenterostomy have an operative mortality of 0.6% to 1%.2 Recurrent ulceration following these procedures varies from 6.8% to 15%.2,3 Vagotomy and hemigastrectomy has an operative mortality of 2.3% to 3%4 with an incidence of recurrent ulceration of 0.8%.4 In comparing the above procedures in regard to the incidence of weight loss and occurrence of


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