AbstractOperation for gastric carcinoma should be undertaken in the presence of known or probable carcinoma of the stomach, in the absence of clear contraindications. These contraindications include serious disease elsewhere (such as cardiac insufficiency, advanced pulmonary disease, and pronounced renal failure), definite objective evidence of distant metastases, and evidence of local extension beyond the point of resectability. To deny a patient the potential benefits of exploratory laparotomy is to eliminate the chance of cure. After thorough exploration of the abdomen, curative resection of gastric cancer involves radical subtotal gastrectomy for lesions restricted to the distal 2/3 of the stomach, and total gastrectomy with splenectomy for lesions in the upper 1/3. When there is local extension of the cancer, resection of adjacent organs should be performed if it appears that the growth can be completely removed. When curative resection is not possible, palliative resection or gastroenterostomy is often indicated to relieve symptoms.