At the Mayo Clinic the most commonly used operation for complications of duodenal ulcer has been the so-called adequate partial gastrectomy. Two undesirable complications, however, sometimes follow this procedure: (1) recurrence of the ulcer and (2) the "dumping syndrome" with malnutrition. Dissatisfaction with recurrent ulceration has been expressed in two large series with longterm follow-up reports: Wallensten in 1954 found recurrence in 8.4% of patients after the Billroth I procedure and in 2.5% after the Billroth II operation. Walters and Lynn in 1957 found an incidence of 7.4% after the Billroth I procedure and of 3.6% after the Billroth II procedure.
The incidence of postoperative malnutrition and the dumping syndrome following subtotal gastric resection also has varied considerably; according to Zollinger approximately 10% of patients have severe symptoms, while Weir and Bennett reported that 23.2% of their series had some degree of these disorders.
An increasing number of reports have