Duodenal Decompression in Gastrectomy

Abstract

THE problems related to dissection and closure of the duodenum in gastrectomy for duodenal ulcer constantly stimulate surgeons to develop improved technics in their management. In general, the methods employed constitute an indirect or a direct approach to treatment of the duodenal ulcer. Representative of the former are the Bancroft operation,¹ McKittrick's two-stage gastrectomy,² vagotomy and gastroenterostomy,³ vagotomy and pyloroplasty⁴ and vagotomy with antral exclusion.⁵ All these methods avoid direct dissection of the ulcer and duodenal closure. They seek to accomplish permanent healing of the retained ulcer or, in McKittrick's procedure, amelioration of local inflammation to permit safer dissection after . . .