The Surgically Treated Chronic Gastric Ulcer: An Extended Followup

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Since the overall results of the medical management of chronic gastric ulcer are discouraging, the records of 595 patients with chronic gastric ulcers who underwent surgical treatment at the Mayo Clinic from 1961 through 1965 were reviewed. Gastric and duodenal ulcer (or sear) occurred together in 18%. Partial gastric resection was the predominant surgical procedure employed. There was an uneventful postoperative course in 83.2% of patients. Early complications occurred in 16.8%, death in 1%, and early reoperation in 3.4% of patients. Followup extended from 1 to 14 years. Late complications occurred in 31.1% of patients. The overall results, graded according to a modified Visik classification, were excellent in 31.9%, good in 48.4%, and unsatisfactory in 8.1%. In patients undergoing partial gastrectomy for “channel ulcers,” the incidence of recurrence was 3.8% with vagotomy and 8.5% without. This is in contrast to a 0 to 1% recurrence rate for ulcers elsewhere in the stomach, with or without truncal vagotomy. For the majority of gastric ulcers, partial gastric resection, with or without vagotomy, remains theoretically advantageous and clinically proven.

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