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Kenneth W. Warren, M.D.
JAMA. 1954;154(10):803-810. doi:10.1001/jama.1954.02940440001001.
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Gastric surgeons have long been wary of injuries to the pancreas during the mobilization of certain benign and malignant ulcers of the stomach or duodenum. Failure to respect the possibilities of injury to the pancreas under such circumstances is an invitation to disaster. Surgeons are less aware, however, of the occurrence of varying degrees of pancreatitis or fulminating pancreatic necrosis following gastric surgery. Schmieden and Sebening1 pointed out many years ago that acute pancreatitis as a complication of surgery on organs adjacent to the pancreas was commoner following operations on the stomach than on any other viscera (table 1). The traditional concept that pancreatic affections related to gastric or duodenal surgery were always secondary to trauma cannot, in our opinion,2 be sustained by a careful analysis of the pertinent data. Millbourn,3 in an excellent survey of this problem, considered many etiological factors and implied that his own


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