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To the Editor.–The excellent paper by Herrington et al (Arch Surg 106:469, 1973) presents a persuasive case for vagotomy-antrectomy as the preferred procedure for chronic duodenal ulcer requiring operation. The operative mortality has progressively dropped to 1.6%. The rate of proved recurrent ulcer is an extremely low 0.6% and clinically satisfactory results are 94%. The case is apparently proved. The authors do concede a place for vagotomy-drainage in poor-risk patients or when a gastric resection may be unduly hazardous.
The authors are not very charitable, however, when they say, "It is difficult, however, to accept the complacency of the proponents of truncal vagotomy-pyloroplasty who willingly accept a 10% to 15% rate of recurrent ulceration and the subsequent need for a second operation of 5% to 10% of patients with the associated increased morbidity and mortality." It is unfortunate that no strong proponent of conservative operations was represented among the
HOERR SO. Operations for Duodenal Ulcer. Arch Surg. 1973;107(6):916-917. doi:10.1001/archsurg.1973.01350240080027