Quantitative Studies on the Effect of Gastric Resection on Secretion of Gastric Juices

The current surgical treatment of duodenal ulcer emphasizes subtotal gastric resection. The aim of this operation is the reduction of the acid-secreting capacity of the stomach, and, indeed, a large experience has shown that following subtotal resection the vast majority of duodenal ulcers heal. A quantitative relationship, however, between the amount of stomach removed and the secretion of acid gastric juice has never been shown. Histologic studies of the stomach have revealed a decrease in the number of parietal cells in the upper part of the fundus and in the cardiac region.¹ Common practice is to remove the lower 75% of the stomach, but does this result in a 75% drop in secretion? Evidence against such a direct relationship is the very high fasting gastric secretion occasionally seen in duodenal ulcer patients who have previously been subjected to subtotal gastrectomy and have subsequently developed stomach ulcers. This hypersecretion of