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Surgical Experiences with Three Hundred Sixteen Duodenal and Marginal Gastric Ulcers

Surgical Experiences with Three Hundred Sixteen Duodenal and Marginal Gastric Ulcers Abstract Hypersecretion of acid gastric juice has been proved by Dragstedt1 to be a constant factor in patients with duodenal ulcer. The basic etiology underlying this constant is, unfortunately, not proved. Until the etiology is completely understood, as Walters2 has pointed out, the modes of treatment and the results will necessarily vary. The literature of the past 10 years is replete with excellent contributions, but the surgical field is still rather sharply divided into radical resectionists on the one side and the vagotomists on the other. Both sides are represented by excellent and conscientious men separated only by approach, not by fundamental concept. Pavlov3 and his group, in 1910, proved beyond question that acid gastric secretion occurs in animals approximately five minutes after the sight, smell, or taste of food, or even the appearance of the feeding attendant. He also proved that this modality was abolished if the References 1. References 20 and 21. 2. References 20 and 21. 3. References 27 and 28. 4. Dragstedt, L. R.: Vagotomy for Peptic Ulcer , Am. J. Med. 8:409-411, 1950.Crossref 5. Walters, W., and Chance, D. P.: Vagotomy as a Prophylactic and Curative Procedure in Peptic Ulcer , J. A. M. A. 153:993-997, 1953.Crossref 6. Pavlov, I. P.: The Work of the Digestive Glands , trans. by W. H. Thompson, New York, J. B. Lippincott Company, 1910. 7. Wolf, S., and Wolff, H. G.: Human Gastric Function: An Experimental Study of a Man and His Stomach , London, Oxford University Press, 1943. 8. Hartzell, J. B.: The Effect of Section of the Vagus Nerves on Gastric Acidity , Am. J. Physiol. 91:161-171, 1929. 9. Dragstedt, L. R.; Woodward, E. R.; Storer, E. H.; Oberhelman, H. A., Jr., and Smith, C. A.: Effect of Antrum Transplantation on Gastric Secretion in Experimental Animals , Proc. Soc. Exper. Biol. & Med. 73:676-678, 1953. 10. Ivy, A. C.: The Mechanisms of Gastric Secretion , Surgery 10:861-878, 1941. 11. Edkins, J. S.: The Chemical Mechanisms of Gastric Secretion , J. Physiol. 34:133-144, 1906. 12. Edkins, J. S., and Tweedy, M.: The Natural Channels of Absorption Evoking the Chemical Mechanism of Gastric Secretion , J. Physiol. 38:263-267, 1908. 13. Ivy, A. C., and McIlvain, G. V.: The Excitation of Gastric Secretion by Application of Substances to the Duodenal and Jejunal Mucosa , Am. J. Physiol. 63:418-419, 1923. 14. Dragstedt, L. R.: Gastric Vagotomy in the Treatment of Peptic Ulcer , Postgrad. Med. 10:323-331, 1951. 15. Dragstedt, L. R.; Oberhelman, H. A., Jr., and Woodward, E. R.: Physiology of Gastric Secretion and Its Relation to the Ulcer Problem , J. A. M. A. 147:1615-1620, 1951. 16. Dragstedt, L. R.; Woodward, E. R., and Camp, E. H.: Question of the Return of Gastric Secretion After Complete Vagotomy , Arch. Surg. 61:775-782, 1950. 17. Woodward, E. R.; Bigelow, R. R., and Dragstedt, L. R.: Effect of Resection of Antrum of Stomach on Gastric Secretion in Pavlov Pouch Dogs , Am. J. Physiol. 162:99-109, 1950. 18. Mann, F. C., and Williamson, C. S.: The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409-422, 1923. 19. Storer, E. H.; Woodward, E. R., and Dragstedt, L. R.: The Effect of Vagotomy and Antrum Resection on the Mann-Williamson Ulcer , Surgery 27:526-530, 1950. 20. Dragstedt, L. R.: Are Gastrojejunal Ulcers Due to Hypersecretion? Arch. Surg , 66:579-581, 1953. 21. Ivy, A. C.: The Problem of Peptic Ulcer , J. A. M. A. 132:1053-1059, 1946. 22. Mayo, H. W.: The Physiologic Basis of Operations for Duodenal, Gastric and Gastrojejunal Ulcer , Surgery 26:251-313, 1949. 23. Allen, A. W.: Surgical Treatment of Duodenal Ulcer , Arch. Surg. 44:501-519, 1942. 24. Allen, A. W., and Welch, C. W.: Subtotal Gastrectomy for Duodenal Ulcer , Ann. Surg. 124:688-707, 1946. 25. Crile, G., Jr.: Technique of Vagotomy and Gastroenterostomy in the Treatment of Duodenal Ulcer , Surg., Gynec. & Obst. 92:309-313, 1951. 26. Pollard, H. M.; Bolt, R. J.; Ransom, H. K., and Orebaugh, J. E.: Comparison of Vagotomy and Subtotal Gastrectomy Five Years Postoperatively , J. A. M. A. 50:1476-1479, 1952.Crossref 27. Grimson, K. S.; Rowe, C. R., Jr., and Taylor, H. M.: Results of Vagotomy During Seven Years: Clinical Observations and Tests of Gastric Secretion , Ann. Surg. 135:631-636, 1952.Crossref 28. Ogilvie, H.: Problem of Peptic Ulceration , Lancet 1:555-560, 1953.Crossref 29. Dragstedt, L. R.; Oberhelman, H. A., Jr.; Evans, S. O., and Rigler, J. P.: Antrum Hyperfunction and Gastric Ulcer , Ann. Surg. 140:396-404, 1954.Crossref 30. Johnson, H. D., and Orr, I. M.: Surg., Gynec. & Obst. 98:425-431, 1954. 31. Johnson, H. D., and Orr, I. M.: Surgical Policy for Peptic Ulcer , Lancet 1:253-257, 1953. 32. Druckerman, L. J.; Weinstein, V. A.; Klingenstein, P., and Colp, R.: Duodenal Ulcer Treated by Subtotal Gastrectomy With and Without Vagotomy , J. A. M. A. 151:1266-1269, 1953. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Surgical Experiences with Three Hundred Sixteen Duodenal and Marginal Gastric Ulcers

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American Medical Association
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Copyright © 1955 American Medical Association. All Rights Reserved.
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0096-6908
DOI
10.1001/archsurg.1955.01270120041006
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Abstract

Abstract Hypersecretion of acid gastric juice has been proved by Dragstedt1 to be a constant factor in patients with duodenal ulcer. The basic etiology underlying this constant is, unfortunately, not proved. Until the etiology is completely understood, as Walters2 has pointed out, the modes of treatment and the results will necessarily vary. The literature of the past 10 years is replete with excellent contributions, but the surgical field is still rather sharply divided into radical resectionists on the one side and the vagotomists on the other. Both sides are represented by excellent and conscientious men separated only by approach, not by fundamental concept. Pavlov3 and his group, in 1910, proved beyond question that acid gastric secretion occurs in animals approximately five minutes after the sight, smell, or taste of food, or even the appearance of the feeding attendant. He also proved that this modality was abolished if the References 1. References 20 and 21. 2. References 20 and 21. 3. References 27 and 28. 4. Dragstedt, L. R.: Vagotomy for Peptic Ulcer , Am. J. Med. 8:409-411, 1950.Crossref 5. Walters, W., and Chance, D. P.: Vagotomy as a Prophylactic and Curative Procedure in Peptic Ulcer , J. A. M. A. 153:993-997, 1953.Crossref 6. Pavlov, I. P.: The Work of the Digestive Glands , trans. by W. H. Thompson, New York, J. B. Lippincott Company, 1910. 7. Wolf, S., and Wolff, H. G.: Human Gastric Function: An Experimental Study of a Man and His Stomach , London, Oxford University Press, 1943. 8. Hartzell, J. B.: The Effect of Section of the Vagus Nerves on Gastric Acidity , Am. J. Physiol. 91:161-171, 1929. 9. Dragstedt, L. R.; Woodward, E. R.; Storer, E. H.; Oberhelman, H. A., Jr., and Smith, C. A.: Effect of Antrum Transplantation on Gastric Secretion in Experimental Animals , Proc. Soc. Exper. Biol. & Med. 73:676-678, 1953. 10. Ivy, A. C.: The Mechanisms of Gastric Secretion , Surgery 10:861-878, 1941. 11. Edkins, J. S.: The Chemical Mechanisms of Gastric Secretion , J. Physiol. 34:133-144, 1906. 12. Edkins, J. S., and Tweedy, M.: The Natural Channels of Absorption Evoking the Chemical Mechanism of Gastric Secretion , J. Physiol. 38:263-267, 1908. 13. Ivy, A. C., and McIlvain, G. V.: The Excitation of Gastric Secretion by Application of Substances to the Duodenal and Jejunal Mucosa , Am. J. Physiol. 63:418-419, 1923. 14. Dragstedt, L. R.: Gastric Vagotomy in the Treatment of Peptic Ulcer , Postgrad. Med. 10:323-331, 1951. 15. Dragstedt, L. R.; Oberhelman, H. A., Jr., and Woodward, E. R.: Physiology of Gastric Secretion and Its Relation to the Ulcer Problem , J. A. M. A. 147:1615-1620, 1951. 16. Dragstedt, L. R.; Woodward, E. R., and Camp, E. H.: Question of the Return of Gastric Secretion After Complete Vagotomy , Arch. Surg. 61:775-782, 1950. 17. Woodward, E. R.; Bigelow, R. R., and Dragstedt, L. R.: Effect of Resection of Antrum of Stomach on Gastric Secretion in Pavlov Pouch Dogs , Am. J. Physiol. 162:99-109, 1950. 18. Mann, F. C., and Williamson, C. S.: The Experimental Production of Peptic Ulcer , Ann. Surg. 77:409-422, 1923. 19. Storer, E. H.; Woodward, E. R., and Dragstedt, L. R.: The Effect of Vagotomy and Antrum Resection on the Mann-Williamson Ulcer , Surgery 27:526-530, 1950. 20. Dragstedt, L. R.: Are Gastrojejunal Ulcers Due to Hypersecretion? Arch. Surg , 66:579-581, 1953. 21. Ivy, A. C.: The Problem of Peptic Ulcer , J. A. M. A. 132:1053-1059, 1946. 22. Mayo, H. W.: The Physiologic Basis of Operations for Duodenal, Gastric and Gastrojejunal Ulcer , Surgery 26:251-313, 1949. 23. Allen, A. W.: Surgical Treatment of Duodenal Ulcer , Arch. Surg. 44:501-519, 1942. 24. Allen, A. W., and Welch, C. W.: Subtotal Gastrectomy for Duodenal Ulcer , Ann. Surg. 124:688-707, 1946. 25. Crile, G., Jr.: Technique of Vagotomy and Gastroenterostomy in the Treatment of Duodenal Ulcer , Surg., Gynec. & Obst. 92:309-313, 1951. 26. Pollard, H. M.; Bolt, R. J.; Ransom, H. K., and Orebaugh, J. E.: Comparison of Vagotomy and Subtotal Gastrectomy Five Years Postoperatively , J. A. M. A. 50:1476-1479, 1952.Crossref 27. Grimson, K. S.; Rowe, C. R., Jr., and Taylor, H. M.: Results of Vagotomy During Seven Years: Clinical Observations and Tests of Gastric Secretion , Ann. Surg. 135:631-636, 1952.Crossref 28. Ogilvie, H.: Problem of Peptic Ulceration , Lancet 1:555-560, 1953.Crossref 29. Dragstedt, L. R.; Oberhelman, H. A., Jr.; Evans, S. O., and Rigler, J. P.: Antrum Hyperfunction and Gastric Ulcer , Ann. Surg. 140:396-404, 1954.Crossref 30. Johnson, H. D., and Orr, I. M.: Surg., Gynec. & Obst. 98:425-431, 1954. 31. Johnson, H. D., and Orr, I. M.: Surgical Policy for Peptic Ulcer , Lancet 1:253-257, 1953. 32. Druckerman, L. J.; Weinstein, V. A.; Klingenstein, P., and Colp, R.: Duodenal Ulcer Treated by Subtotal Gastrectomy With and Without Vagotomy , J. A. M. A. 151:1266-1269, 1953.

Journal

A.M.A. Archives Surgery – American Medical Association

Published: Jun 1, 1955

References

  • Vagotomy for Peptic Ulcer
    Dragstedt , L. R.
  • Vagotomy as a Prophylactic and Curative Procedure in Peptic Ulcer
    Walters , W., and Chance, D. P.
  • The Work of the Digestive Glands
    Pavlov , I. P.
  • Human Gastric Function: An Experimental Study of a Man and His Stomach
    Wolf , S., and Wolff, H. G.
  • The Effect of Section of the Vagus Nerves on Gastric Acidity
    Hartzell , J. B.
  • Effect of Antrum Transplantation on Gastric Secretion in Experimental Animals
    Dragstedt , L. R.; Woodward, E. R.; Storer, E. H.; Oberhelman, H. A., Jr., and Smith, C. A.
  • The Mechanisms of Gastric Secretion
    Ivy , A. C.
  • The Chemical Mechanisms of Gastric Secretion
    Edkins , J. S.
  • The Natural Channels of Absorption Evoking the Chemical Mechanism of Gastric Secretion
    Edkins , J. S., and Tweedy, M.
  • The Excitation of Gastric Secretion by Application of Substances to the Duodenal and Jejunal Mucosa
    Ivy , A. C., and McIlvain, G. V.
  • Gastric Vagotomy in the Treatment of Peptic Ulcer
    Dragstedt , L. R.
  • Physiology of Gastric Secretion and Its Relation to the Ulcer Problem
    Dragstedt , L. R.; Oberhelman, H. A., Jr., and Woodward, E. R.
  • Question of the Return of Gastric Secretion After Complete Vagotomy
    Dragstedt , L. R.; Woodward, E. R., and Camp, E. H.
  • Effect of Resection of Antrum of Stomach on Gastric Secretion in Pavlov Pouch Dogs
    Woodward , E. R.; Bigelow, R. R., and Dragstedt, L. R.
  • The Experimental Production of Peptic Ulcer
    Mann , F. C., and Williamson, C. S.
  • The Effect of Vagotomy and Antrum Resection on the Mann-Williamson Ulcer
    Storer , E. H.; Woodward, E. R., and Dragstedt, L. R.
  • Are Gastrojejunal Ulcers Due to Hypersecretion?
    Dragstedt , L. R.
  • The Problem of Peptic Ulcer
    Ivy , A. C.
  • The Physiologic Basis of Operations for Duodenal, Gastric and Gastrojejunal Ulcer
    Mayo , H. W.
  • Surgical Treatment of Duodenal Ulcer
    Allen , A. W.
  • Subtotal Gastrectomy for Duodenal Ulcer
    Allen , A. W., and Welch, C. W.
  • Technique of Vagotomy and Gastroenterostomy in the Treatment of Duodenal Ulcer
    Crile , G., Jr.
  • Comparison of Vagotomy and Subtotal Gastrectomy Five Years Postoperatively
    Pollard , H. M.; Bolt, R. J.; Ransom, H. K., and Orebaugh, J. E.
  • Results of Vagotomy During Seven Years: Clinical Observations and Tests of Gastric Secretion
    Grimson , K. S.; Rowe, C. R., Jr., and Taylor, H. M.
  • Problem of Peptic Ulceration
    Ogilvie , H.
  • Antrum Hyperfunction and Gastric Ulcer
    Dragstedt , L. R.; Oberhelman, H. A., Jr.; Evans, S. O., and Rigler, J. P.
  • Surgical Policy for Peptic Ulcer
    Johnson , H. D., and Orr, I. M.
  • Duodenal Ulcer Treated by Subtotal Gastrectomy With and Without Vagotomy
    Druckerman , L. J.; Weinstein, V. A.; Klingenstein, P., and Colp, R.