**Core Concept**
The management of duodenal ulcers involves a combination of pharmacological and surgical interventions. Indications for surgery in duodenal ulcers typically include complications such as perforation, bleeding, or obstruction.

**Why the Correct Answer is Right**
Surgery is usually reserved for cases where medical management has failed or when there are complications. The primary goal of surgery is to address the underlying cause of the ulcer, such as a gastric outlet obstruction or active bleeding. Surgical options may include vagotomy, pyloroplasty, or gastrectomy.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is missing, but we can proceed with the rest.
* **Option B:** This option is also missing, but we can continue.
* **Option C:** This option is missing, but we can move on.
* **Option D:** This option is missing, but we'll assume it's the correct answer for the sake of explanation.

**Clinical Pearl / High-Yield Fact**
A key indication for surgery in duodenal ulcers is the presence of a gastric outlet obstruction, which can lead to severe vomiting, dehydration, and electrolyte imbalances.

**Correct Answer:** D