Of the 450 patients with complicated duodenal ulcer disease, in 23 (5.8%) the ulcer was located distally to the duodenal ampulla. On the basis of studying the results of surgical treatment, a conclusion is made, that the selective proximal vagotomy in combination with the ulcer excision and duodenoplasty is an operation of choice in complicated retroampullary ulcers. The operative interventions correcting the disturbances in the duodenal patency in preserved function of the pyloric sphincter contribute to prevention of duodenogastric reflux and alkaline reflux-gastritis.