Gastric outlet obstruction is an infrequent complication of peptic ulcer. Such obstruction may produce large losses of acid gastric secretions by vomiting. These losses superimposed upon inadequate nutritional and fluid intake often result in serious metabolic problems. There is disagreement as to preoperative and operative management of these patients; some surgeons have found a high incidence of postoperative gastric outlet obstruction when vagotomy is performed in conjunction with gastric resection or a drainage procedure. This paper reviews our experience with the manifestations of obstructing peptic ulcer and the results of surgical therapy.
Since 1960, 48 patients have been operated upon at the St. Louis University Hospital or Cochran Veterans Administration Hospital for gastric outlet obstruction due to peptic ulcer. The criteria for inclusion in this study were: (1) radiographic demonstration of obstruction to the emptying of barium from the stomach, and (2) demonstration of peptic ulceration or scarring at