Parietal cell vagotomy. A 23-year study.

Abstract

The authors studied the long-term ulcer recurrence rate after elective parietal cell vagotomy (PCV) for duodenal, pyloric, or prepyloric ulcers. Recurrent ulceration rates of around 10% are reported after PCV. Recurrence rates are, however, proportional to the duration of follow-up. Series presenting long-term follow-up are sparse in the literature. From 1969 to 1979, 350 patients underwent elective PCV. Three hundred forty-seven accessible patients were observed prospectively at intervals of 1 to 5 years to detect recurrent ulcers. The median duration of follow-up was 140.2 months (range 1 month-22.75 years). Seventy-six of the 347 patients (21.9%) developed recurrent ulcers. Calculation of the integrated ulcer recurrence rate indicates a constant monthly recurrence risk of 0.16%. Recurrences occurred as late as 17 3/4 years after operation. Eighty per cent of the recurrences occurred after 10 years of follow-up. The results confirm that the rate of recurrent ulceration after PCV is proportional to the duration of follow-up.