COMBINED VAGUS RESECTION AND PARTIAL GASTRECTOMY FOR DUODENAL AND MARGINAL ULCER

Abstract
IN JULY, 1947, we initiated a program of combining a partial gastrectomy with a bilateral infradiaphragmatic vagus resection in the surgical treatment of duodenal or marginal ulcer. It was our purpose to determine whether the addition of vagectomy could improve our over-all results of partial gastrectomy and make it a practical supplement in future surgical therapy. At that time, the assumption was, first, that the addition of vagus resection might, because of postoperative persistent achlorhydria, result in the elimination of postoperative marginal or stomal ulcer; second, that it might, because of the delayed emptying time of the gastric remnant, result in reducing the incidence and severity of the dumping syndrome, and, third, that if both the aforementioned factors could be modified by such a procedure, this combined procedure might, at a future date, permit with safety a less radical gastric resection, thereby allowing for a larger gastric pouch, which would