October 27, 1928


Author Affiliations


JAMA. 1928;91(17):1259-1262. doi:10.1001/jama.1928.02700170023008

The year 1881 marks an epoch in the history of peptic ulcer. It was in that year that Nicoladoni suggested to his chief, Wölfler, the operation of gastro-enterostomy, soon thereafter performed for the first time by Wölfler. This, however, was the anterior method. Billroth is credited with having advised limited resection of the stomach for carcinoma, but the first pylorectomy was performed by Pean in 1879. The patient died. Billroth performed the first successful operation in 1881. This has come to be known as Billroth's first method, soon abandoned by him and supplanted by his second method, which has continued more or less in favor to the present day.

In 1885 von Hacker proposed the posterior method of performing gastro-enterostomy. A few years later, Peterson of Czerny's clinic shortened the loop. This really led to the adoption of the posterior method as the operation of choice, the one almost universally

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