Role of Antral Exclusion in Development of Peptic Stomal Ulcer. ∗

Abstract

Conclusions

1. Exclusion of the antrum from continuity with the residual gastric pouch is the chief ulcerogenic factor in the Sauvage operation in which the antrum is anastomosed to the esophagus (Group II dogs). 2. Stomal peptic ulcer was not observed in vagally innervated total gastric pouches when the antrum remained in contact with the residual gastric pouch (Group I dogs). 3. Augmentation of the secretion of acid from an isolated Heidenhain pouch attends antral migration or exclusion (Group II dogs). Diminution of secretion from such a pouch was observed when the vagally innervated entire stomach, with the antrum in its normal position, was attached to the side of the duodenum as a blind pouch (Group I dogs).