Vagotomy, accompanied by either gastroenterostomy or pyloroplasty, has become the most commonly used operation for duodenal ulcer. A few specialised units prefer selective vagotomy which preserves the extragastric vagal fibres running to gall bladder, pancreas and small bowel.1 2 Some surgeons also use vagotomy to treat gastric ulcer.1–3 These procedures are at least as successful as partial gastrectomy,4 but the metabolic effects may be less severe. The main postoperative problems are recurrent ulcer and a specific form of diarrhoea.
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