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April 1971

Vagotomy and Drainage ProceduresFor Duodenal Ulcer Incidence and Effect of Incomplete Vagal Section

Author Affiliations

St. Louis
From the Department of Surgery and Surgical Service (Unit II), St. Louis University; Department of Surgery and Surgical Service (Unit I), Washington University; and the John Cochran Veterans Administration Hospital, St. Louis.

Arch Surg. 1971;102(4):242-247. doi:10.1001/archsurg.1971.01350040004002

One hundred and seventy-one patients were treated by vagotomy and drainage for duodenal ulcer. When performed electively, the mortality was low (0.9%). For massive, continuing hemorrhage the mortality was high (22.2%). There was an 11.1% overall incidence of ulcer recurrence. The number of vagal trunks resected did not establish the completeness of vagotomy. Insulin testing was performed postoperatively in 60 patients. Of these, 22 (37%) were positive. A positive insulin test was associated with a high incidence of recurrent ulcer (60%). There were no recurrences in those patients with negative or equivocal Hollander tests. We believe that routine postoperative insulin tests are a valuable prognostic guide.