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June 3, 1974

Late Effects of Gastrectomy

JAMA. 1974;228(10):1287-1289. doi:10.1001/jama.1974.03230350057038

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ALTHOUGH undesirable symptoms may follow gastrectomy, compensation for induced physiologic abnormalities generally occurs. When the operation is carried out for benign disease, such as duodenal or gastric ulcer, the patient usually judges the results as excellent or highly satisfactory. When cancer of the stomach is considered, there is no reasonable alternative to ablative therapy.

This brief summary will not stress the favorable features of gastrectomy such as the elimination of malignant disease and the cure or amelioration of symptoms of other diseases of the stomach and duodenum. Attention will be directed toward the unhappy sequelae. They depend primarily on the physiologic changes that are induced by gastrectomy, and secondarily on clinical factors.

Physiological Sequelae of Gastrectomy  The most important physiological result of gastrectomy is the loss of a food reservoir that discharges intermittently into the intestine. In addition, there are specific losses of hydrochloric acid, intrinsic factor, gastric mucus, and