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March 1957

Observations Based on Two Hundred Forty-Five Consecutive Gastrectomies for Duodenal Ulcer Disease at Brooke Army Hospital: Comparison of Two Groups of Billroth II Gastrectomies

Author Affiliations

U. S. Army
From the Surgical Service, Brooke Army Hospital, Fort Sam Houston, Texas (Lieut. Col. Schirmer); Chief, Department of Surgery and Chief, General Surgery Service, Brooke Army Hospital; Chief of Clinical Surgery, Army Medical Service School; Surgical Consultant, Fourth Army Headquarters; Professor of Surgery, Graduate School, Baylor University; now Chief, Department of Surgery, Tripler Army Hospital, A. P. O. 438, San Francisco (Col. Bowers).

AMA Arch Surg. 1957;74(3):447-458. doi:10.1001/archsurg.1957.01280090145019

Introduction  Years of experience and clinical investigation into the cause of duodenal ulcer and the results of treatment have resulted in some general agreement as to factors involved in the pathogenesis of the ulcer and the general methods of management of patients. With respect to the technical aspects of surgical operations designed to cure duodenal ulcer, however, there remains a wide diversity of opinion. There are advocates of Billroth I and Billroth II types of operation, large- or small-stoma, vagotomy with or without gastroenterostomy, antecolic or retrocolic anastomosis, and recently even a proponent of staged procedures for treatment of the disease beginning with gastroenterostomy as a preliminary procedure.1True comparisons between the end-results of operations which are technically different, but performed on the same general type of patient population by surgeons with similar equipment and treatment facilities, are not often reported. This analysis is thought to be of value