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PREOPERATIVE AND POSTOPERATIVE CARE OF PATIENTS WITH LESIONS OF THE STOMACH AND OF THE DUODENUM

WALTMAN WALTERS, M.D., D.Sc.; HOWARD R. HARTMAN, M.D.
Arch Surg. 1940;40(6):1063-1082. doi:10.1001/archsurg.1940.04080050026004.
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The principles that underlie the preoperative preparation of patients who have lesions of the stomach and of the duodenum are concerned for the most part with attempts to facilitate compensation for the effects of obstruction with its associated metabolic disturbances, such as dehydration and avitaminosis, and with anemia due to hemorrhage. Although these principles are applicable in the main to the preparation of patients for operation, they apply equally well when like conditions develop postoperatively. However, the appearance of such conditions subsequent to operation fortunately is of infrequent occurrence. Although the principles of preoperative therapy directed toward control of physiologic chemical changes are similar to those of postoperative treatment, the patient's response to the acute phases of postoperative complications may be more severe, with a much greater general systemic reaction than the response to some chronic phase that exists prior to operation. In the latter instance there is usually sufficient

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