[Skip to Navigation]
July 1950

TOTAL GASTRECTOMY: An Investigation of the Merits of End to End Esophagoduodenostomy

Author Affiliations

Fellow in Surgery, Mayo Foundation ROCHESTER, MINN.
From the Division of Surgery, Mayo Clinic.

Arch Surg. 1950;61(1):102-114. doi:10.1001/archsurg.1950.01250020105012

CREDIT for the first successful total gastrectomy goes to Schlatter,1 who in 1897 reported his case in which gastrointestinal continuity was reestablished by means of an esophagojejunal anastomosis. It was just one year later that Brigham2 accomplished the operation successfully by employing an end to end esophagoduodenostomy. In the following years total gastrectomy was performed in isolated instances, with a rather forbidding mortality rate. As the years passed the operation was extended to more and more cases, until at present it has become a rather standard procedure.

Pack and McNeer3 have presented surveys of the trends and have commented on the decline in popularity of esophagoduodenostomy during the intervening years. In their reports of an early series covering the years 1884 through 1920, the end to end method was employed in 41.3 per cent of the cases. In the interval, 1921 through 1930, the incidence of the