In most cases, anti-ulcer medications heal the ulcers quickly and effectively. Eradication of H. pylori prevents most ulcers from recurring. However, some people do not respond to medication or they develop complications. They may require surgical intervention.
The common types of surgery for ulcers are vagotomy, pyloroplasty, and antrectomy.
In this surgery the vagus nerve, which transmits messages from the brain to the stomach, is cut. Interrupting these messages sent through the vagus nerve reduces acid secretion. However, there can be side effects. The surgery may also interfere with stomach emptying. The newest variation of this surgery involves cutting the only parts of the nerve that control the acid-secreting cells of the stomach. This avoids the parts of the nerve that influence stomach emptying
In this surgery, the lower part of the stomach (antrum) is removed. This section produces a hormone that stimulates the stomach to secrete digestive juices. Sometimes a surgeon may also remove an adjacent part of the stomach that secretes pepsin and acid. A vagotomy is usually done in conjunction with an antrectomy.
This surgery enlarges the opening into the duodenum and small intestine (pylorus), which enables stomach contents to pass more freely out of the stomach. A vagotomy may also be performed along with a pyloroplasty.