EVALUATION OF ELECTIVE SURGICAL TECHNIQUE S FOR ULCER

Elective surgical treatment of peptic ulcers is less important after t he introduction of effective conservative treatment. However, in a chr onic recurrent disease all options of treatment have a place. In duode nal ulcer highly selective vagotomy is the procedure of choice despite the high recurrence rate, since it has a low operative risk and a low rate of early postoperative morbidity or late sequelae. In gastric ul cer distal partial gastrectomy (Billroth I) must be recommended using the same criteria. Laparoscopic techniques will not alter the indicati on for surgery; these procedures are still hampered by technical probl ems and the main problem of high recurrence rate after vagotomy is not solved by choosing a different approach to the abdomen. Surgical trea tment of peptic ulcers must be revalidated in respect to health care r eform.