Tubeless Gastric Surgery

Abstract

BLOOD GROUPS AND DISEASE BDRmH MEDICAL JOURNAL frequency of CDe/cDE and MN people may be found, unless care is taken to study only those who have not been transfused. Previous transfusion may possibly be the explanation of the high CDe/cDE frequency found in duodenal ulcer by Buckwalter and Tweed (1962). We are grateful to the Research Committee of the United Liverpool Hospitals under the chairmanship of Lord Cohen of Birkenhead, to the Medical Research Council, and to the Nuffield Foundation for generous grants towards this work. AIDDNDUM.-Since writing this paper we have Rhgrouped (1) a series of 139 duodenal ulcer patients while they were in hospital, (2) a series of 111 duodenal ulcer patients who have not been in hospital for at least a year, and (3) a control series of 256. We found the CDeIcDE frequencies to be 26.62%, 16.21%, and 12.89% respectively. After the blood groupings had been carried out we studied the case sheets of the first series and found that approximately 50% of the patients had had a recent previous blood transfusion. Our figures, therefore, are in agreement with the theoretical frequencies given in this paper and are further evidence of previous recent blood transfusion being able to account for Buckwalter and Tweed's (1962) finding of a high CDe/cDE frequency in duodenal ulcer. REFERENCES

Late results of bilateral selective vagotomy and pyloroplasty for duodenal ulcer: 5–9-year follow-up

“…Gastric decompression by means of a nasogastric tube was never used in these patients, nor was any other procedure such as gastrostomy. The credit for this great advance goes to Garden Hendry, who since 1947 has eliminated the use of the tube in his patients (Hendry, 1962). Other authorities have also recognized that its use is unnecessary (Burge, 1964;Herrington, 1965;Stein and Lans, 1966;., 1968).…”

An evaluation and comparison of the early and late results of standardized Polya gastrectomy.

“…Priestley (1954) described an almost identical post-operative routine and stressed the importance of not allowing the patient to 'give in' to the early sense of fullness which many experience due to their suddenly reduced capacity. In more recent years Hendry (1962) has championed the concept. Delayed gastric emptying has occasionally necessitated the passage of a stomach tube but no other difficulties have been encountered.…”

Annual review of surgery 1972

“…Post-operative gastric suction Because of the fear that the denervated stomach would fail to empty after vagotomy, nearly all surgeons in the early days of this procedure employed either post-operative nasogastric suction or else gastrostomy drainage of the stomach for a period of up to 10 days following surgery. With increasing experience, more and more surgeons in the United Kingdom have given up this practice, adopting what Hendry (1962) called 'tubeless gastric surgery'. We found, for example, that even in the presence of gross pyloric stenosis post-operative nasogastric suction was not required following vagotomy and either pyloroplasty or gastrojejunostomy (Ellis, 1972).…”