Results of Subtotal Gastrectomy for Duodenal and Anastomotic Ulcer

THE SURGICAL treatment of peptic ulcer disease of the stomach and duodenum continues to be critically reviewed. Procedures other than the conventional subtotal gastrectomy are now being advocated, specifically vagotomy and antrectomy, 50% gastrectomy with vagotomy, and vagotomy with a drainage procedure. Palumbo and others^1-3 have reported very favorable results with antrectomy and bilateral vagectomy for chronic duodenal ulcer. Smithwick et al⁴ evaluated recurrent ulceration after various operations based upon acidity and peptic activity of the gastric contents, and found recurrent ulceration less frequent with hemigastrectomy and vagotomy than with subtotal gastrectomy. The results of these studies are based upon many patients who have had follow-up for less than five years. Time may or may not change the results. Recently Welch et al^5,6 reviewed partial gastrectomy for duodenal ulcer and their results at the Massachusetts General Hospital from 1952 through 1962. They felt their results from partial