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June 14, 1947

TREATMENT OF DUODENAL ULCERS: Partial Gastrectomy versus Palliative Resection

JAMA. 1947;134(7):571-575. doi:10.1001/jama.1947.02880240007002

In 1927 I presented, before the American Medical Association, a paper on partial gastrectomy versus gastroenterostomy in the surgical treatment of duodenal ulcers.1 At that time the group of physicians performing gastroenterologic surgery at the Mount Sinai Hospital then headed by Dr. A. A. Berg was trying to introduce gastric resection with removal of the duodenal ulcer as an operation of choice.

The importance of this more radical operation for the avoidance of postoperative peptic ulcer was first emphasized by Haberer2 in 1920. He pointed out that in order to achieve satisfactory results three criteria had to be met: (1) removal of the duodenal ulcer, (2) removal of the pylorus and (3) resection of at least 60 per cent of the stomach. The omission of the first two steps of this procedure cannot be compensated by increasing the extent of the resection toward the cardia.

At the outset