Abstract

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.