Importance of Appraising the True Gastric Acidity After Subtotal Gastrectomy

When he does a subtotal gastrectomy, the surgeon is often asked how much of the stomach he removes in order to perform an adequate resection. While every surgeon has certain measurements and criteria that he applies to this problem, he is actually not in a position to answer the question adequately. By his standards he is able to state the procedure that he considers will produce an adequate resection anatomically but is unable to give assurance that the resection will be adequate physiologically. For the patient, however, it is vital that the resection be adequate in the latter sense, for on it depend his chances of remaining free of new ulcer disease. Studies of gastric secretion after subtotal gastrectomy and attempts to correlate these with the amount of stomach resected indicate that the removal of apparently equal portions of the stomach in different patients anatomically fails to produce similar effects