[Causes of death in surgically treated ulcer patients. Results from the Aarhus County Vagotomy Trial].
It is a well-known observation that patients submitted to operation for benign duodenal or gastric ulceration have reduced long-term survival as compared with the basic population. This excessive mortality may attributed to association between peptic ulceration and other conditions, particularly pulmonary disease, cirrhosis of the liver and suicide. In order to investigate whether there is a difference in the pattern of causes of death in patients treated with classical gastric resection and patients treated the vagotomy methods employed in recent years, an analysis of the causes of death in 169 patients was undertaken. During the years 1972-1977 these patients had been treated with selective gastric vagotomy with drainage, selective gastric vagotomy with antrectomy, parietal cell vagotomy with or without drainage for duodenal ulceration, pyloric ulceration, prepyloric ulceration or combined ulceration. This is termed the Aarhus County Vagotomy Trial. Comparison with the basic population reveals statistically significant excessive mortality from gastro-intestinal disease including the subgroups benign ulcer disease and cirrhosis of the liver and accidents including the subgroup of suicide. The mortality from malignant conditions did not differ significantly from the control group with the exception of significantly increased incidence of cancer of the stomach. The death ratio was increased for cancer in the lungs and pancreas but this was not statistically significant. These results are in agreement with reviews based on resection materials apart from the observation that a significant excess mortality from cancer of the stomach was demonstrated in this patient group in the present investigation which is not a constant finding in previous investigations. In addition, no increased incidence of benign pulmonary disease could be demonstrated.