The rationale of antrectomy and vagotomy for duodenal ulcer.

Abstract

ALTHOUGH the basic cause of duodenal ulcer remains unknown, the importance of gastric acidity is a generally accepted premise motivating the treatment of this lesion. On this basis, in recent years, the surgical treatment of most cases of duodenal ulcer has consisted of more or less radical subtotal gastrectomy and of vagotomy combined with a drainage procedure. More recently some interest has been aroused by the favorable results following combined antrectomy and vagotomy in the treatment of this lesion. To date this procedure has been attended by diminished incidence of weight loss and anemia than in subtotal gastrectomy, less motility disturbances than in vagotomy and gastroenterostomy, and less marginal ulcers than in both procedures. Experience has shown that nothing short of total gastrectomy will completely prevent the occurrence of marginal ulcer. This, of course, is too radical a procedure for a benign lesion. It seems feasible then that more consideration