During the formative years of modern surgery the quest for a rational operation for cancer of the stomach laid the foundations of our present knowledge and practice in this field. Thus, by virtue of necessity pylorectomy became one of the original procedures of a major character within the abdomen. In 1906 Moynihan characterized it as "an operation of generous promise."
Modern reflection cannot fail to direct attention to the fact that the early doctrines associated with this surgical measure have endured. Among the ablest of pioneers to apply the dual principles of surgery and physiology was Billroth. He was the first to observe the great muscular hypertrophy associated with cancer of the pylorus and stated his belief that pyloric obstruction from this cause was responsible for one half of the deaths before adhesions and glandular infection became factors of importance. Billroth's operations were marked by a simplicity which alined them
TRUESDALE PE. PYLORECTOMY: REPORT OF A FOLLOW-UP STUDY OF FORTY CASES. JAMA. 1928;91(14):1001–1006. doi:10.1001/jama.1928.02700140003001
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