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April 1971

Vagotomy and Drainage Procedures: For 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.

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