The Effect of Gastroenterostomy on the Gastrin Mechanism

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Abstract
During the first quarter of this century simple gastrojejunostomy was considered by many to be the surgical treatment of choice for duodenal ulcer; its technical ease, combined with low operative risk, was a prime factor leading to its extensive use. It was some years before it was realized that the rate of marginal ulceration was very high, probably in the neighborhood of 40%. As a result of this observation, the operation fell into disrepute and was not often used as the sole procedure in treating duodenal ulcer. Since the marked interdigestive hypersecretion of acid gastric juice characteristic of the patient with duodenal ulcer is unaltered by gastroenterostomy, it is surprising indeed that approximately 60% of such patients seemingly remained well. After the introduction of vagotomy for the treatment of duodenal ulcer in 1943,1 gastroenterostomy as an ancillary procedure was found useful in promoting more adequate gastric drainage. A small

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