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The Book Forum
April 20, 1964

Partial Gastrectomy: Complications and Metabolic Consequences

JAMA. 1964;188(3):330. doi:10.1001/jama.1964.03060290134060

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In this very interesting book the authors have focused their attention upon the early and late complications and metabolic consequences of partial gastrectomy. Extensive original observations provide the basic material, though the discussion also includes a careful review of the literature. The senior author's descriptive terms (eg, "afferent loop syndrome," "loop-the-loop obstructions," "sumping") illuminate his great interest in the mechanical defects of Billroth II operations that often have been performed in a somewhat unorthodox fashion and referred to him for repair. When he converted to a Billroth I with vagotomy, the majority of his patients have been relieved completely.

The late complications, "mechanical embarrassment of the afferent and efferent loops," "infection of the afferent loop," dumping, disturbances of fat metabolism leading to diarrhea, or malnutrition, iron deficiency, and defective calcium absorption) are all described in great detail. Severity of the sequelae are not under-emphasized; for example, anemia is estimated to

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