In 1914, when most surgeons considered gastroenterostomy the proper surgical therapy for duodenal ulcers, we devised a method for pyloric closure in this operation, using submucous fascial transplants from the fascia lata. We found that this procedure was much more difficult in an inflamed stomach with a duodenal ulcer than it had been in dogs. In a number of cases the pyloric antrum was torn so badly that, as a means to an end, we did a subtotal gastrectomy. These were our first cases of subtotal gastrectomies, and we noted that the results with this operation were much more satisfactory than they had been with a simple gastroenterostomy.
Advocating subtotal gastrectomy as the operation of choice for duodenal ulcer, we presented six such cases at a meeting of the Chicago Surgical Society in 1915. Many of our colleagues at that time opposed this operation on the principle that radical surgical