Radical Subtotal Gastrectomy for Peptic Ulcer Disease:  A Clinical and Laboratory Evaluation

The decision regarding the type of surgical procedure to be done for a patient with peptic ulcer disease is hampered by the difficulty of an intelligent evaluation of the published results of surgery. This is due to the fact that accurate descriptions are often not given of the exact extent of resection or of the nature of the anastomoses performed. It seems valuable, therefore, to continue to examine, by careful clinical studies, certain points which are still unsettled. The one chosen for appraisal here is the effect of the extent of resection on postoperative nutrition and symptoms.

Visick¹ reported on a "measured radical gastrectomy" which removed all the stomach but 3 in. of the greater curvature and 1½ in. of the lesser curvature. Observation² of these patients at postoperative intervals averaging 2.6 years showed that 81% had less than 10% weight loss, a figure comparable to that (namely,