The number of patients undergoing definitive duodenal ulcer operation at Charlotte Memorial Hospital and Medical Center declined by 75 percent from 1971 to 1985. The percentage of women making up the total study population increased to 40 percent in the period from 1981 through 1985. Average patient age also increased. Fewer gastric resections are now being performed and emergency operations are becoming more frequent, with bleeding being the most common indication. Splenic lacerations requiring splenectomy in patients undergoing vagotomy occurred in 3.1 percent of the study population during the 15 year study. The overall mortality rate for elective operations was 1.5 percent and for emergency operations, 17.2 percent. The incidence of acute duodenal ulcer perforation increased during this 15 year study. Duodenal ulcer operations have changed in number and in type as the manifestations of the disease have become altered by trends that began in the mid 1950s and became exaggerated by more effective ulcer therapy.