Cimetidine or parietal-cell vagotomy in patients with juxtapyloric ulcers.
83 patients with severe juxtapyloric ulcers were randomly allocated to either long-term cimetidine treatment (400-800 mg/day) or to parietal-cell vagotomy (PCV). All were followed up for more than 3 years. The endoscopically proven relapse-rate with a dose of 400 mg at bed time was 54%; it fell to 32% when the dose was increased to 400 mg twice a day. In the PCV group the relapse-rate was 33%. Patients with prepyloric ulcers alone or in combination with duodenal ulcers relapsed at a higher rate (57% and 82%, respectively) than did patients with "pure" duodenal ulcer disease (17% and 14%, respectively). No patient, not even those with a history of bleeding or perforated ulcers, experienced any bleeding or perforation during relapses, either when on long-term cimetidine treatment or after operation. Previous haemorrhage or perforation per se is thus not an indication for surgery in favour of maintenance treatment with cimetidine.
D000328:Adult; D000368:Aged; D002927:Cimetidine / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011897:Random Allocation; D012008:Recurrence; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000601:surgery; D014628:Vagotomy; D014629:Vagotomy, Proximal Gastric
D002927:Cimetidine