Comparison of Surgical Options for Peptic Ulcer Disease

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 AntrectomyTruncal Vagotomy and DrainageHighly Selective Vagotomy
Mortality rate1% to 2%0.5% to 0.8%0.05%
Recurrence rateLowModerateHigh
Dumping10% to 15%10%1% to 5%
Diarrhea20%25%1% to 5%

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