Abstract A STANDARD routine for studying the effects of various surgical procedures upon the acidity of the gastric contents of ulcer patients has been used in this clinic for several years. Previous reports1 have dealt with gastric acidity under fasting (basal) conditions and in response to neurogenic and chemical stimuli in normal persons and in ulcer patients. Secretory responses have been studied before and after gastric resections of various extent, alone and combined with sympathectomy or vagotomy. The clinical and laboratory results following removal of approximately 50% of the stomach combined with vagotomy indicate that of all the combinations studied, the best protection against the development of gastrojejunal ulceration is afforded by this operation. Similar investigations on dogs have been carried out simultaneously with the clinical studies. Previous papers from the experimental laboratory discussed the assessment of gastric secretory responses in general,2 the effects of 50% gastrectomy combined with References 1. (a) Smithwick, R. H., and Kneisel, J. J.: The Effect of Resection of the Sympathetic and Parasympathetic Innervation of the Stomach upon Gastric Acidity , Rev. Gastroenterol. 17:439, 1950. 2. (b) Farmer, D. A.; Howe, C. W.; Porell, W. J., and Smithwick, R. H.: The Effect of Various Surgical Procedures upon the Acidity of the Gastric Contents of Ulcer Patients , Ann. Surg. 134:319, 1951.Crossref 3. Howe, C. W.; Porell, W. J., and Ware, P. F.: Assessment of Gastric Secretory Responses in Relation to Peptic Ulcer: Method of Study and Control Data on 39 Normal Dogs , A. M. A. Arch. Surg. 63:234, 1951.Crossref 4. Effects of Sympathectomy Alone and Combined with Gastrectomy on Gastric Secretory Responses: Experimental Study on Esophageal-Fistula Dogs, with Normal Stomachs , Howe A. M. A. Arch. Surg. 64:238, 1952.Crossref 5. Ware, P. F., and Howe, C. W.: Experimental Esophageal and Pharyngocervical Fistula , A. M. A. Arch. Surg. 63:229, 1951.Crossref 6. Farmer and associates.1b Howe and associates.2 7. Several changes in the study routine have recently been made as a result of experience to date. Samples during the 1-hour basal and broth periods are now collected in three 20-minute aliquots. The insulin period has been shortened to two hours, during which four half-hour aliquots are collected. Representative samples from each period are used for pepsin determinations. The histamine test has been omitted. All tests are run on the same day. 8. Smithwick, R. H.: Total Gastrectomy with Particular Reference to Closed (Aseptic) Esophagojejunostomy , New England J. Med. 237:39, 1947.Crossref 9. Porell, W. J., and Howe, C. W.: Assessment of Gastric Acidity and Pepsin in Relation to Peptic Ulcer: I. Acidity of Gastric Contents , Boston M. Quart. 2:73, 1951. 10. Visick, A. H.: Measured Radical Gastrectomy: Review of 505 Operations for Peptic Ulcer , Lancet 1:505, 1948.Crossref
A.M.A. Archives Surgery – American Medical Association
Published: Nov 1, 1952
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