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September 1959

Studies in Duodenal Ulcer Surgery: II. Effect of Partial Antrectomy and Vagotomy on Acidity

Author Affiliations

Miami, Fla.; New York
Present address of Dr. Martin: Department of Surgery, Jackson Memorial Hospital, Miami.; Department of Surgery of the College of Physicians and Surgeons of Columbia University and the Surgical Service of the Presbyterian Hospital, New York.

AMA Arch Surg. 1959;79(3):507-509. doi:10.1001/archsurg.1959.04320090155024

Introduction  Among the proponents of vagotomy in the surgical treatment of duodenal ulcer, the preferred method of dealing with the gastric antrum remains controversial. Antral hyperfunction has been implicated as causative in the recurrence of peptic disease following vagotomy alone and vagotomy in combination with a drainage procedure.2,3,8 Consequently, many clinicians regard the removal of the entire antrum as mandatory in the surgical control of gastric acid hypersecretion.In recent years, however, some laboratory Work has predicated an inhibitory action of the antrum on gastric acidity under certain conditions.1,4,6,9 In addition, clinical studies on patients who have undergone surgical procedures for duodenal ulcer disease in Which the antrum was not removed have shown an apparently adequate ablation of gastric hyperacidity.10 And further, it has been demonstrated that a small remnant of gastric antrum elicits no significant stimulation of gastric secretion,5,7 and is dependent upon the antral

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