[The role of exclusion gastrectomy in gastroduodenal pathology]

Following a gastrectomy for exclusion performed 13 years ago with an excellent result at the time of an ulcerous recurrence after vagotomy, the authors have extended that indication to the "large stenosis" characterized by a huge gastric bag down to the pelvis minor including a plentiful stasis liquid, and by presenting some non-reversible sclerotic lesions. The results obtained have confirmed the merits of such technics of which the indications have been clearly expressed. The technic consists of not dissecting the ulcer, but to do stitches on the 2 cm stump, its mucous membrane having been resected, of the pyloric antrum. So stump complications are eliminated as well as biliary-pancreatic risks. The authors' experience is based on 54 case reports (6 females and 48 males) with a follow-up of an average of more than 7 years. 13 patients underwent in November 1987 an endoscopic control. Gastrectomy for exclusion with resection of the mucous membrane of the pyloric antrum appears to the authors as a permissible indication in treating "large African stenosis" as well as stenotic recurrence following a "Dragstedt" operation.