The proper surgical treatment of gastric and duodenal ulcers is a much debated question at the present time. For many years gastric and duodenal ulcers were treated by gastro-enterostomy. It soon became evident to a number of surgeons that simple gastro-enterostomy did not affect the life cycle of a gastric ulcer. When pylorospasm accompanies gastric ulcer, gastro-enterostomy may relieve symptoms. However, it does not in any way minimize the dangers of a penetrating gastric ulcer; viz., perforation, hemorrhage and malignant degeneration. Furthermore, gastro-enterostomy not only fails to cure the gastric ulcer but renders the patient liable to the development of a gastrojejunal ulcer.
In an attempt to attack gastric ulcers by a direct method, the following procedures were gradually developed:
1. Local Excision, With or Without Gastro-Enterostomy.
—Local excision is applicable only in very small ulcers which are freely movable and do not involve the posterior wall of the stomach.
LEWISOHN R. GASTRODUODENAL ULCERS: PARTIAL GASTRECTOMY VERSUS GASTRO-ENTEROSTOMY IN THEIR SURGICAL TREATMENT. JAMA. 1927;89(20):1649–1652. doi:10.1001/jama.1927.02690200001001
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