Before effective medical therapy for peptic ulcers was introduced, patients with severe persistent symptoms were referred for surgery. By the early 1970’s nearly 18,000 operations for peptic ulcer were performed each year in England and Wales, but this number began to decline even before cimetidine was introduced in 1976.1 Since then the number of patients with peptic ulcer disease referred for surgery has continued to decline slowly but steadily as more patients are treated medically with the highly effective drugs now available.
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