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September 1984

The Appropriate Ulcer Cure

Arch Surg. 1984;119(9):1099-1100. doi:10.1001/archsurg.1984.01390210089022

To the Editor.—I wish to commend Dr Nyhus for his excellent commentary on the future of the proximal gastric vagotomy.1 However, woven through his discussion, as in all surgical literature, is a basic philosophy that increases rather than alleviates the frustration encountered in dealing with peptic ulcer disease, which is that the search is on for one comprehensive, one-time operation for ulcer disease, regardless of circumstances. Yet all this study is of a disease that has consistently proved itself to be more complex, as time and technology have helped us discover. Originally, the ulcer was thought to be simply a local phenomenon and was only excised. As more was learned about the physiology involved, more intricate and generally successful procedures were devised. Yet recurrence remains a problem, so much so that it would seem prudent to stop and ask whether the basic assumptions are universally valid.

A few

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