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Stephen J. Stempien, M.D.; Franklin B. Wilkins, M.D.; Joseph A. Weinberg, M.D.
JAMA. 1952;149(5):416-418. doi:10.1001/jama.1952.02930220006002.
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Vagotomy in the surgical treatment of duodenal and anastomotic peptic ulcers has been reported as a satisfactory procedure by large clinics with a wide experience with this method.1 In our experience with more than 600 vagotomies, success has depended on the following four factors: (1) a careful selection of patients, (2) the skill and experience of the surgeon in achieving a complete vagotomy, (3) the incorporation of a drainage procedure, preferably pyloroplasty, to avoid retention, and (4) the prolonged postoperative management of the patient until gastrointestinal function has been readjusted.

We wish to report in this paper our experience with the selection of patients for surgery. This subject needs much more careful attention and emphasis than it has received in the medical literature. The accompanying table illustrates the contrast in percentage distribution of patients by the primary indications for surgery between the first 350 cases1d in our


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