What are the long-term outcomes and risks for complications after truncal vagotomy and drainage, truncal vagotomy and antrectomy, and highly selective vagotomy?
Truncal vagotomy and antrectomy, although having the lowest recurrence rate, also has the highest morbidity and mortality. Highly selective vagotomy, although having the lowest morbidity and mortality, has the highest recurrence rate. The surgeon must balance these issues, patient preference, and the pathophysiology of the ulcer type in question when choosing an operative plan.
Comparison of Surgical Options for Peptic Ulcer Disease
|Truncal Vagotomy and Antrectomy||Truncal Vagotomy and Drainage||Highly Selective Vagotomy|
|Mortality rate||1% to 2%||0.5% to 0.8%||0.05%|
|Dumping||10% to 15%||10%||1% to 5%|
|Diarrhea||20%||25%||1% to 5%|