During the past 25 years our surgical group, utilizing three affiliated hospitals, has performed vagotomy-antrectomy on 3,584 patients. The follow-up has been 98%. The operative mortality has declined from 3.1% in the 1950s to the present mortality of 1.6%. The overall satisfactory results with the combined procedure has been 94% and the recurrent ulcer rate is 0.6%.
The clinical study supports the concept that vagotomy-antrectomy is the most effective operation to prevent recurrent ulceration. It can be performed with safety in most patients with complications of ulcer, but it is contraindicated in the high-risk individual and in circumstances where dissection about the duodenum would prove hazardous. Vagotomy-antrectomy remains the procedure of choice and lesser operations for ulcer are used in only certain selected cases.