The satisfactory results of surgical treatment of such a variable pathologic lesion as chronic peptic ulcer should be increased by the selection of the safest and most satisfactory operation for each condition.
The introduction of a plastic pylorojejunostomy with excision of the ulcer, when it is indicated, offers considerably less risk than a gastric resection. It will also permit side-tracking the ulcer with a more normal gastric physiology and less danger of jejunal ulcer than by closing the pylorus and performing a gastrojejunostomy.
A number of factors have a bearing on the choice of surgical treatment of peptic ulcer.
In the etiology of ulcer, infection has been considered of both primary and secondary importance. While acute ulcers may be produced experimentally by infection, it is likely that similar lesions arising clinically promptly heal in the absence of a spasmophilic tendency or ulcer diathesis (Alvarez1).
Ivy and Fauley2 failed