Bleeding duodenal ulcer--treatment strategy. A follow-up study.

In a follow-up study of 40 patients operated on for a bleeding vessel in a duodenal ulcer by means of ligation, pyloroplasty and vagotomy, we found that 9 patients (23%) suffered from recurrent bleeding, with a fatal outcome in 7 cases (78%). We conclude therefore that this method is unsuccessful, and if haemostasis is not achieved by endoscopic electrocoagulation operative resection is suggested. Where resection indicates too high a risk to the patient, we suggest that the operative procedure is reduced to ligation of the bleeding vessel combined with a medical vagotomy in the form of an H2-receptor antagonist.