Role of Antral Exclusion in Development of Peptic Stomal Ulcer.

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Abstract
In a series of dogs the gastric antrum was separated from the parietal cell segment of the stomach and the stomach was divided from the esophagus. The antrum was then anastomosed to the esophagus end-to-end, and the parietal cell pouch to the duodenum end-to-side. Approx. two-thirds of these dogs developed chronic stomal ulcers at the anastomosis between the parietal cell pouch and the duodenum. Secretion of previously standardized Heidenhain pouches also increased markedly as a result of this operation. In another series of dogs, the stomach was separated from the duodenum at the pyloric sphincter and the stomach from the esophagus. The duodenum was anastomosed to the esophagus end-to-end, and the total stomach pouch was anastomosed to the duodenum end-to-side. None of these dogs developed stomal ulcers and Heidenhain pouch secretion decreased markedly following this operation. Exclusion of the antrum from the remainder of the stomach apparently is the essential factor in the development of stomal ulcers in this type of exptl. prepn.

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