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September 1961

Acute Massive Duodenal Ulcer Hemorrhage: Direct Suture Control and Vagotomy Pyloroplasty

Author Affiliations


Arch Surg. 1961;83(3):428-435. doi:10.1001/archsurg.1961.01300150102013

Heuer1 has stated that in bleeding duodenal ulcer the primary object of surgery is to control hemorrhage and to save life. Subtotal gastrectomy with removal of the ulcer is generally accepted as being the only procedure available that can be relied upon to do this, despite the formidable risk under these trying circumstances.

Dragstedt's2 recommendation of vagotomy as a less radical and more physiologic procedure for dealing with ulcer diathesis led us to begin using it exclusively, together with pyloroplasty, for surgical treatment of duodenal ulcer. Since 1946 we have employed this in nearly 300 patients, with only 3 surgical deaths and with 94% satisfactory long-term results.

Early in our experience3-5 the thought occurred to us that in the case of bleeding duodenal ulcer perhaps direct suture of the bleeding point, previously considered unreliable, might now be depended upon to control bleeding, if combined with vagotomy to