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The lesser curve gastric mucosa was examined endoscopically in 60 patients, 3 to 6 days after performing proximal gastric vagotomy. Minor and equivocal changes were seen in only 3 patients. Three patients had adjunctive splenectomy but did not show any evidence of mucosal vascular insufficiency in the proximal stomach. Our findings do not confirm a report from other investigators of lesser curve gastric ulceration attributed to partial ischaemia short of lesser curve necrosis. Endoscopy should be considered in patients developing unexplained features following proximal gastric vagotomy.

The clinical results of gastric mucosal resection are reported after a 1-10-year follow-up in which 76 per cent of patients were followed up for more than 5 years. There were 3 postopertive deaths in 152 patients. Mucosal antrectomy with vagotomy for duodenal ulcer in 96 patients, and for recurrent ulcer in 9 patients, has not been followed by a single recurrence. Gastric mucosal resection alone for the treatment of gastric ulcer in 21 patients resulted in 1 recurrence. Although vagotomy combined with resection is currently out of fashion for the initial treatment of duodenal ulcer in Britain, mucosal gastric resection has technical advantages in combination with vagotomy for the cure of recurrent ulcers following duodenal ulcer surgery.

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