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GASTRO-ENTEROSTOMY WITH EXCLUSION OF INOPERABLE CANCER OF PYLORUS AND ANTRUM

GEORGE T. PACK, M.D.; ISABEL M. SCHARNAGEL, M.D.
JAMA. 1934;102(22):1838-1841. doi:10.1001/jama.1934.02750220016006.
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Gastro-enterostomy with exclusion of cancer of the pylorus and antrum may be the first step in a two-stage resection or may be indicated as a palliative measure for inoperable cancers of this location. The advantages, indications and technic of this operation are presented here, with a review of the evolution of this procedure.

The treatment of choice for operable gastric carcinoma is resection of the stomach. This procedure is not tolerated well by patients in poor general condition with tumors of questionable operability because of fixation, surrounding inflammatory reaction and enlarged perigastric nodes. We have previously explained the advantages and indications for using two stages in resections under these conditions.1 The first stage, consisting of exclusion of the carcinomatous segment of the stomach with gastro-enterostomy, may be done under a local anesthetic and requires little more time than gastro-enterostomy alone. The patient receives a liberal postoperative diet so that

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