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To the Editor:—
The article by E. D. Kiefer on this subject (The Journal, Nov. 14, 1942) may change the whole aspect of surgical treatment of duodenal ulcer. If radical operation is followed by jejunal ulcer in as many as 7 per cent of the cases then our conception that gastrectomy is superior to gastroenterostomy has to be revised.However, an analysis of the 12 cases reported in Dr. Kiefer's paper does not permit the assumption that the results of radical operation in duodenal ulcers are "tragically disappointing" as far as postoperative jejunal ulcers are concerned.As a matter of fact, in 7 of the 12 cases no radical operation but Finsterer's method was used, and according to a personal communication of Dr. Kiefer in 2 cases of the remaining 5 gastric resection was done not for duodenal ulcer alone but for duodenal ulcer plus gastroenterostomy plus jejunal ulcer. In
Nissen R. "JEJUNAL ULCERS AND RECURRENT HEMORRHAGES AFTER PARTIAL OR SUBTOTAL GASTRECTOMY. JAMA. 1943;121(2):147. doi:10.1001/jama.1943.02840020055019
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