A 75-year-old man is admitted with epigastric pain, anemia, and weight loss. On upper gastrointestinal endoscopy, a large ulcer is found in the distal antrum. The biopsy report shows adenocarcinoma of the stomach. CAT scan of the liver shows no metastasis. You would recommend:
A subtotal gastrectomy with negative margins is appropriate treatment for gastric carcinoma. Vagotomy adds nothing as patients with gastric cancer are invariably achlorhydric. A Whipple procedure is done for pancreatic carcinoma. Total gastrectomy is rarely indicated for a distal gastric carcinoma.
Whipple procedure (pancreaticoduodenectomy)
Vagotomy and antrectomy
Subtotal gastrectomy
Vagotomy and pyloroplasty with wedge resection of the ulcer
Stomach & Duodenum