It is reported about 79 repeated interventions because of an ulcer pepticum jejuni and its relapses. The high rate of relapses to about 30 percent even after repeated interventions requires a radical concept of the reduction of acid. If a subsequent resection is necessary vagotomy should always be carried through, if possible in form of a selective vagotomy, vagotomy alone in case of a not penetrating flat ulcer or small residue of the stomach. If the general somatic condition of the patient allows it, duodenal passage should be carried through by means of the jejunal interposition. The examinations of the preoperative secretion have their greatest value in finding extragastric acid stimulators or antrum residues left behind.