LONG-TERM CLINICAL-RESULTS OF HIGHLY SELECTIVE VAGOTOMY PERFORMED BETWEEN 1988 AND 1990

A retrospective analysis was conducted of 778 patients who underwent h ighly selective vagotomy between 1980 and 1990. Surgery was performed for duodenal ulcers weithout any complications in 485 (62.3 %) patient s; for duodenal ulcers with complications such as stenosis, bleeding, or perforation in 270 (34.7%); for combined duodenal and ventricular u lcers in 12 (1.5%), and for ventricular ulcers alone in 11 (1.4%). Pyl oroplasty was additionally performed in the presence of complications only, The incidence of intraoperative complications proved to be as hi gh as 1.4%, occurring in 11 patients, while postoperative complication s developed in 247 patients (31.7%), Although the overall mortality wa s 0.6% (5 patients), the mortality rate of those patients who underwen t surgery for uncomplicated ulcer disease was 0.2% only (2 patients). The patients comprised 554 men (71.2%) and 224 women (28.8%) with an a verage age of 41.4 +/- 0.7 years. The average duration of duodenal ulc er disease was 9.5 years, and 643 (83.2%) of the patients were able to be regularly followed up for between 3 and 13 years. Recurrence devel oped in 62 patients (9.6%): in the duodenum in 57 patients (91.9%), an d in the stomach in 5 (8.1%). The rate of recurrence according to sex: was 9.4% in men and 10.3% in women, being 42 and 20 patients, respect ively. The average duration until recurrence appeared,pas 27.06 +/- 3. 44 months. A reoperation proved necessary in 28 of these 62 patients ( 45.1%). The clinical results were evaluated by means of a modified Vis ick classification, according to which 81.8% of the patients belonged to groups 1 or 2, 7.9% to group 3, and 10.3% to group 4.