The results of surgery in 232 cases of peptic ulcer complicated by pyloric obstruction have been reviewed and the results of different operative procedures compared.SummaryIn this series vagotomy and drainage gave much better results in the presence of pyloric obstruction than in the treatment of peptic ulcer in general, whereas the results of Pólya gastrectomy appear marginally worse. It appears that the risk of stomal ulceration is the major difference, as the stomal ulcer rate for vagotomy and drainage in the presence of pyloric obstruction was 2% as compared with 8% in the total series. Conversely, the incidence of stomal ulcer following gastrectomy appears to be slightly increased. These findings suggest that vagotomy with drainage is the treatment of choice in pyloric obstruction