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gastric ulcer
The pyloric stomach wall of 12 healthy organ donors and of resection specimens of 28 patients suffering from a gastric ulcer are investigated.
      
The size of the gastric ulcera prored of no value in differentiating between gastric ulcer and carcinomatous ulcer.
      
Four main groups of gastroduodenal ulcers are known: gastric ulcer, duodenal ulcer, stomal ulcer and the group of acute ulcers (stress ulcer, steroid ulcer, bleeding erosive gastritis).
      
Both frequency and extension of gastric ulcer were accumulated significantly.
      
History, clinical features and pathogenesis of high gastric ulcer are discussed.
      
The essential cause of gastric ulcer is found in disease of the pyloric channel.
      
Billroth I gastroduodenostomy was performed for chronic gastric ulcer, acute bleeding ulcer, technically inadequate vagotomy, and small antral carcinoma in elderly patients.
      
The results of selective proximal vagotomy and pyloroplasty for duodenal and gastric ulcer in 464 patients over the last 5 years were evaluated in 438 cases.
      
HH is combined with duodenal ulcer in 12 percent of cases operated on, and with gastric ulcer in only 4 percent.
      
In 29 patients with gastric ulcer, 6 recurrent ulcers were observed in 17 patients after SPV alone, and no recurrent ulcer was noted in the 12 patients treated by SPV and pyloroplasty.
      
Somatostatin treatment led to immediate cessation of the bleeding after 1 h in 3 patients with fresh gastric ulcer, while in 2 patients with callous gastric ulcer somatostatin was ineffective.
      
"Anyone who claims to have discovered the ideal procedure in the treatment of gastric ulcer, should be considered immodest." These words by Schnitzler (1914) are in principle still valid.
      
Gastric ulcer is caused by the reflux of duodenal juice (e.g., lysolecithin, which is capable of corroding the mucosal barrier of the stomach.
      
These new types of treatment may also be useful in gastric ulcer.
      
Recurrence of gastric ulcer became apparent in 9.3% after one year and in 3.4% after two years.
      
The general operative procedure should be performed after emergency endoscopy: highly selective vagotomy with three vessel ligatures in duodenal ulcer, partial gastrectomy in gastric ulcer, and intensive conservative treatment in acute ulcerations.
      
Five (14.3 %) postoperative deaths occurred, yet only one due to technical failure; three patients died of hepatic coma and one of a perforated gastric ulcer.
      
At the Surgical Clinic of Cologne a gastric resection was performed on 632 patients for gastric ulcer between 1956 to 1979 (BIn = 129, BIIn = 503).
      
After resection because of a gastric ulcer, the incidence of carcinoma was 8 times as high as after an operation for a duodenal ulcer.
      
The main indication was gastric ulcer (n =161), followed by duodenal ulcer (n = 78), including an emergency operation in the event of bleeding and perforation.
      
 

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