The long-term effects of vagotomy and drainage, parietal cell vagotomy and H2 receptor antagonists on duodenal ulcers and gastric function and structure

This paper presents a comparative retrospective analysis of the effects of vagotomy and drainage, parietal cell vagotomy (PVC) and maintenance H2 receptor antagonist (H2RA) therapy on ulcer recurrence rates, clinical status, gastric acid secretion, serum gastrin responses and gastric structure in the elective treatment of duodenal ulcer. The results indicate that the operations offered greater protection against recurrent ulceration, and that H2RA therapy provides some protection against recurrence while the patient is on continued treatment but does not alter the natural history of the disease when treatment is stopped. The evidence to date suggests that neither PCV nor H2RA therapy has altered the conventional indications for surgical treatment in duodenal ulceration.