Surgeons have more patients of stomach disease than others in surgical department. The Surgical
treatment of stomach disease is variable and its effectiveness also is not definitive.
For these reasons, authoe made clinical study on 166 cases of gastrectomy which were performed
at the P.N.U. Hospital and other clinics by auther himself from November 1956 to May 1969 and
following results were obtained.
1. The material used in this study were 611 gastrectomy cases contained 174cases of gastric ulcer,
180 cases of duodenal ulcer, 18 cases of combined ulcer, 5 gastritis, 232 cancer and 2 miscellaneous
cases.
2. Peak incidence was 32.7% gastric ulcer in the age group of 41 to 50, 40.5% duodenal ulcer,
38.8% combined ulcer and 66% in gastrics in the group of 31 to 40 and 36.6% stomach cancer in
the age group of 51 to 60 respectably.
3. Male to female ratio was dominantly high in male: 9:1 in gastric ulcer, 11:1 in duodenal ulcer,
8:1 in combined ulcer and 2.6:1 in stomach cancer.
4. Chief complaints of preoperative period in order of frequency were as follows: Indigestion 327
cases (87%), upper abdominal pain 235 cases (63%) in begin stomach diseases but upper abdominal
pain cases 210 (90.5%), indigestion cases 205 (88.2%), anemia 194 cases (83.6%), palpable mass
198 cases (80.5%), weight loss 109 cases (46.9%) in stomach cancer.
5. In the benign stomach diseases. 43.8% of cases continued to have symptoms during 3∼5 years.
In stomach cancer, 30.1% of cases complained less than 3 months in 3∼6 months in 28.8%, 6
months∼1 year in 2.54% and less than 1 year in 84.4% respectably.
6. In benign gastric cancer, te hemoglobin ranged from 11 gm% to 15 gm% in 53.8% and A
type was 35.6%, while in malignant gastric cancer the hemoglobin ranged from 6gm% to 11gm% in
53.8% and A type was 27.0%.
Gastric analysis showed 61.5% normochlorhydria and 25.6% hypochlorhydria in gastric ulcer,
83.7% hyperchlorhydria in duodenal ulcer and 61.7% achlorhydria in gastric cancer. Appearance of
occult blood was 79.0% in the benign gastric diseases and 80.6% in the stomach cancer.
7. Operative procedures were 4 Billroth I having 3 gastric ulcer and 1 duodenal ulcer, 5 vagotomy
with antrectomy having I duodenal ulcer, 2 combined ulcer, and 2 gastritis, 171 partial distal
gastrectomy in gastric ulcer, 313 subtotal gastrectomy contained 178 duodenal ulcer, 16 combined
ulcer, 3 gastritis and 116 stomach cancer, 54 radical subtotal gastrectomy, 10 radical gastrectomy
with additional procedures, 29 total gastrectomy and 4 esophagogastrectomy in stomach cancer.
8. The location of the lesion was as follows: In benign gastric lesions, 72.4% at pyloric in gastric
ulcer 98.3% at duodenal first portion in duodenal ulcer, 72.2% at body of stomach in combined
ulcer and 47.4% at pylorus in stomach cancer,
9. The early postoperative results were follows: Among the benign gastric lesions, partial gastrec
tomy cases have excellent 59.6%, good 31.5% fair 2.8% poor 5.8%. Gastroduodenostomy cases
had excellent 75%, good 25% and vagotomy with antrectomy cases had excellent 40%, good 60%
and subtotal gastrectomy cases have excellent 69.8%, good 21.1%, fair 8.4%, poor 0%. Among
the stomach cancer, subtotal gastrectomy cases had excellent 67.2%, good 21.1%, fair 6%, poor
6.8% and radical gastrectomy cases have excellent 59.2%, good 25.8%, fair 7.4%, poor 6.8% and
radical gastrectomy cases with additional procedures had excellent 17.2% good 51.6%, fair 33.3%
and total gastrectomy cases had excellent 24.1%, good 34.4%, poor 13.7%, and esphagogastrectomy
had good 50%. poor 25.0%.
10. The postoperative complications were noticed in 50 cases(8.1%): wound infection was common,
15 cases (2.4%) and the cases of reoperation were 7 cases (1.1%).
11. The operative mortality rate was 1.6% (10 cases).
12. The late results of postgastrectomy were as follows: In 130 benign stomach diseases cases
66.5% of them revealed excellent results, good 28.6%, fair 2.2%, poor 2.2%.
In 82 cases stomach cancer, the following results were observed.
65 cases (79.3%) living less than 3 months,
54 cases (65.8%) over 3 months to 6 months,
34 cases (41.4%) living over 6 months to 1 year,
20 cases (24.3%) living over 1 year to 2 years,
17 cases (20.7%) living over 2 to 3 years,
13 cases (15.8%) living over 3 to 4 years,
4 cases (0.7%) living over 4 to 5 years,
1 case (1.2%) living over 5 to 10 years,
1 case (1.2%) living over 10 years.
13. The causes of death were 5 renal failure, 2 cardiac failure, 1 pneumonia and 1 liver failure.
7.
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