DISASTER

VAGOTOMY FOR PEPTIC ULCERATION THE MAJORITY of patients who undergo surgery for peptic ulceration are cured of their complaint. Pain is relieved, the ulcer does not recur and complications such as bleeding and perforation are prevented. This result is achieved by gastrectomy or by one of the three forms of vagotomy: (i) truncal (which severs the whole trunk of the vagus as it enters the abdomen); (ii) selective (which spares the extragastric fibres); and (iii) parietal cell (which preserves both extragastric fibres and fibres supplying the antrum). However, 5% to 20% of patients who undergo surgery for peptic ulceration subsequently have significant problems. The number of such patients in our community is appreciable, as surgery for peptic ulceration is performed frequently.