The surgical pendulum is swinging toward universal adoption of the recent more conservative type surgical procedures which have been developed in a number of surgical centers during the past 20 years. As a result of the findings of several investigators, particularly the monumental work of Dragstedt and associates, the basic altered gastric physiology in the pathogenesis of duodenal ulcer is now known and understood. By the clinical application of these basic physiologic principles, several surgeons have patterned conservative surgical procedures to control duodenal ulcer without affecting, to any serious degree, the normal gastric functions or nutritional status of the patients. In addition, several of these procedures have reduced the incidence and severity of many of the undesirable postoperative sequelae associated with many of the older and time-tested surgical procedures for this chronic disease.It has been definitely established by careful research studies that there are two major physiologic phases
PALUMBO LT, SHARPE WS. Distal Antrectomy With Vagectomy for Duodenal Ulcer: Review of 450 Cases. Arch Surg. 1963;87(6):1040–1047. doi:10.1001/archsurg.1963.01310180156026
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