Selective proximal vagotomy (SPV) and pyloroplasty were used in 383 patients with duodenal ulcers and 55 with gastric ulcers; the results were retrospectively evaluated 5-9 years postoperatively. In elective surgery the mortality was 1.8 %, in emergency operations 8.9 % (20.1 for bleeding, 5.5 ~ for perforation). Relaparotomy became necessary in 6.8 % and the rate was 3.2 during the first hospital stay. In 11.1~ symptomatic recurrent ulceration developed 6 months to 6 years postoperatively. Recurrent ulcers were observed in 9.1 ~o; 50 ~o were treated operatively. In a period of 5 -9 years after SPV and pyloroplasty, 5.59/0 of the patients complained of dumping and 4.8 % of diarrhea. According to the Visick grading system, results were poor in 9.1%, satisfactory in 10~o, and good or excellent in 80.9~o.Zusammenfassung. 383 Ulcus duodeni-und 55 Ulcus ventriculi-Patienten, bei denen eine selektiv proximale Vagotomie (SPV) mit Pyloroplastik durchgeffihrt wurde, werden retrospektiv 5-9 Jahre postoperativ ausgewertet. Die Letalitfit der Elektiveingriffe betrug 1,8 ~o, die der Notfalloperationen (20,1 ~o Ulcusblutungen, 5,5~ Ulcusperforationen) 8,9~. 6,8% der operierten Patienten muBten relaparotomiert werden. W/ihrend der ersten station/iren Behandlung war eine Reoperation in 3,2 ~o notwendig. Symptomatische Rezidiv-Ulcera entwickelten sich in 11,1 ~o innerhalb yon 0,5-6 Jahren postoperativ. Gesicherte Ulcusrezidive lagen in 9,1~ vor, yon denen je die Hfilfte operativ und konservativ behandelt wurden. 5 -9 Jahre nach SPV mit Pyloroplastik klagten 5,5 ~ der Patienten fiber Dumping und 4,8 % fiber Diarrhoen. Nach dem Visick-Schema hatten 9,1% der Patienten ein schlechtes, 10 % ein befriedigendes und 80,9 ~o ein gutes und exzellentes Ergebnis.

Within 11 years 279 operations for acute bleeding from gastroduodenal ulcers were performed at the surgical University Clinic in Würzburg. Of the 279 patients, 140 had to be operated on immediately because of acute severe bleeding. Of the 158 bleeding duodenal ulcers, 104 had a selective proximal vagotomy (SPV), 29 had gastric resection, and in 25 the ulcer was simply closed. The overall mortality after SPV was 8.6%, 62% after gastric resection, and 40% after simple suture ligation. Recurrent bleeding occurred in 8.7% after SPV, 10.3% after gastric resection, and in 24% after suture ligation. Of the 89 bleeding gastric ulcers, 25 had a selective proximal vagotomy, 30 a gastric resection, and 34 excision of the ulcer. The overall mortality after SPV was 16%; after gastric resection it was 23.3% and 41.2% after ulcer excision. Recurrent bleeding was observed in 8% after SPV, in 10% after gastric resection and in 11.7% after ulcer excision.