[The role of the Billroth I operation peptic ulcer surgery]

The conviction is expressed that none of the operations today available for treatment of peptic ulcer is always effective for all types of patient; the surgeon must in fact be able to select and perform the operation most suitable for each case. In this connection the advantages and disadvantages of gastric resection according to Billroth's first method are considered. The fundamental stages of this operation are described in detail, with a critical analysis of the various pathological conditions in which its performance is indicated or, on the contrary, there is a precise contraindication. On the basis of the main parameters of judgment (follow-up, operating mortality, relapse rate, dumping syndromes and Visick's scale) obtained from personal experience and wide research on literature, a comparative evaluation is then made between Billroth I and other operations commonly used in treatment of gastroduodenal ulcer. In conclusion it is asserted that Billroth I is a technically good, physiological operation capable of ensuring immediate and long-term results not inferior to those of Billroth II and other operations; it therefore deserves to be considered among the methods of choice and more widely used.