TY - JOUR T1 - ULcer surgery and highly selective vagotomy—y2k AU - Donahue PE Y1 - 1999/12/01 N1 - 10.1001/archsurg.134.12.1373 JO - Archives of Surgery SP - 1373 EP - 1377 VL - 134 IS - 12 N2 - WHILE ulcerations of the stomach and duodenum remained common entities in the latter half of the 20th century, the number of operations performed for ulcer declined remarkably. Medical treatments became effective as specific medications (the histamine-receptor antagonists and proton-pump inhibitors [PPIs]) eliminated the deleterious effects of intraluminal acid, greatly reducing the need for operations.1 Subsequently, bacterial infection was proven to be a major risk factor for gastric and duodenal ulcers, especially for ulcer recurrence, which was eliminated in 98% of those at risk by antibiotics directed against Helicobacter species.2- 3 For the first time in history, medical treatments for ulcer were clearly more effective than ulcer operations; ulcer surgery, once the only "definitive" therapy, is perceived as a heroic intervention, reserved for patients without other alternatives. SN - 0004-0010 M3 - doi: 10.1001/archsurg.134.12.1373 UR - http://dx.doi.org/10.1001/archsurg.134.12.1373 ER -