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Use in Surgical Treatment of Duodenal Ulcer

HENRY N. HARKINS, M.D.; NILES D. CHAPMAN, M.D.; LLOYD M. NYHUS, M.D.; ROBERT E. CONDON, M.D.; JOHN K. STEVENSON, M.D.; JOHN E. JESSEPH, M.D.

AMA Arch Surg. 1962;85(6):936-943.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In the initial portion of this paper the "combined operation" will be discussed from 2 standpoints, first, physiologic basis, and second, technique. Each of these 2 headings will be further discussed regarding the 3 main steps of the procedure: vagotomy, antrectomy, and gastroduodenal anastomosis, considering the physiologic basis and then the technical performance, respectively, of each of these steps. The paper will close with a brief presentation of our clinical experience and a conclusion.

I. Physiologic Basis of the Combined Operation

Medical and surgical therapy of peptic ulcer disease alike depend upon decreasing or neutralizing the secretion of acid and pepsin (Fig. 1). The success of the combined operation is the result of its ability to alter normal mechanisms of gastric secretion and to block the pathways over which abnormal secretory stimuli are known to operate.

Gastric juice is produced only in response to specific stimuli that are divided into . . . [Full Text PDF of this Article]

Author Affiliations
SEATTLE

Professor and Executive Officer, Department of Surgery, University of Washington School of Medicine (Dr. Harkins); Instructor in Surgery, University of Washington School of Medicine, (Dr. Chapman); Associate Professor of Surgery, University of Washington School of Medicine (Dr. Nyhus); Postdoctoral Research Fellow, National Heart Institute (Dr. Condon); Assistant Professor of Surgery, University of Washington School of Medicine (Dr. Stevenson); Assistant Professor of Surgery, University of Washington School of Medicine (Dr. Jesseph).; From the Department of Surgery, University of Washington School of Medicine.

Footnotes
Received for publication Feb. 9, 1962.

Presented as a Scientific Exhibit at the 46th Clinical Congress, American College of Surgeons, San Francisco, Oct. 10-14, 1960, and at the 110th Annual Meeting of the American Medical Association, New York, June 25-30, 1961 (Certificate—Honorable Mention).

Supported by Grants-in-Aid from the National Institutes of Health (A3071, A4010, A3898).

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