Selective surgery for duodenal ulcer

Abstract

It has long been known that there is a wide range of acid output in patients with chronic duodenal ulcer, and that different operations for duodenal ulcer have different acid-lowering effects. Selective surgery for duodenal ulcer is the concept that a patient with high acid output needs an operation with a greater acid-lowering effect than a patient with a low acid output. In 1936, Somervell and Orr1090 introduced this principle by advocating gastrojejunostomy in patients with not very marked hyperacidity, and partial gastrectomy for those with excessive hyperacidity.1088–9 Since then there have been many such schemes in which various increasingly radical operations, with increasingly acid-lowering effects, have been used in patients with higher acid outputs.