THERE IS no general agreement as to the operation of choice for chronic duodenal ulcer. While feeling that no operation can be used for every patient, it has been routine practice for many years in Doctor R. L. Holt's surgical unit at Manchester Royal Infirmary, England, to treat most chronic duodenal ulcers by the operation of vagotomy and "anterior pylorectomy." In "anterior pylorectomy," a small lozenge is excised from the anterior aspect of the pyloric sphincter and adjacent stomach and duodenum and the defect repaired transversely. In our opinion, there can be little difference functionally between this and the Heineke-Mikulicz type of pyloroplasty and the operation should be considered a type of pyloroplasty. No attempt was made at selective vagotomy in any of these operations. In order to assess the use of vagotomy and a pyloric drainage procedure in the surgical treatment of duodenal ulcer it is important to establish