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The treatment of chronic peptic ulceration


J.H. Louw

Abstract

Gastric and duodenal ulcers are different entities. The duodenal ulcer is a problem for the physician while the gastric ulcer is a  problem for the surgeon. In duodenal ulcer the object of treatment is reduction of acid output by control or elimination of   hypersecretion of gastric juice especially as far as the cephalic phase is concemed. In those cases that have earned surgical  treatment gastric vagotomy is, therefore, of fundamental importance, and the best complementary procedure to eliminate the  antral phase of gastric secretion is either antral resection or 'physiological  antrectomy' by an adequate drainage operation. In  gastric ulcer the fear of  carcinoma masquerading as a benign ulcer must still dictate the policy of  management in our community. For this reason timely surgical intervention is recommended. Indeed, medical treatment without a thorough work-up to exclude  malignancy is condemned as unscientific - I would go further and say, unethical. The main purpose of therapy is protection or   removal of the sick gastric mucosa and the surgical treatment of choice remains distal gastrectomy  which includes the ulcer.

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eISSN: 2078-5135
print ISSN: 0256-9574