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Hemigastrectomy and Vagotomy for Duodenal Ulcer

Arch Surg. 1964;88(5):860-865. doi:10.1001/archsurg.1964.01310230136026.
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Subtotal gastrectomy has proved to be a good procedure for control of complications of duodenal ulcer. It is not uniformly effective, however, as 2%-4% of patients so treated ultimately develop recurrence. Also, this procedure is associated with the development of postgastrectomy sequelae which may be disabling. These limitations of gastrectomy have led many surgeons to search for a more effective procedure, with a lower incidence of postoperative sequelae. During recent years a trend toward more conservative operative procedures has emerged. Some, such as vagotomy and gastrojejunostomy, are associated with a higher incidence of recurrent ulceration but a lower incidence of postoperative physiologic disturbance. One procedure, hemigastrectomy and vagotomy, has been reported to reduce the incidence of ulcer recurrence without an increase in postgastrectomy sequelae.2,9,12 Palumbo et al, who have utilized antrectomy and vagotomy, report a lowered incidence of both recurrent ulceration and the dumping syndrome.10

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