MASSIVE BOWEL RESECTION

Experience with thirty-five patients having lesions which produced death of massive portions of the small bowel is reviewed. Early operation is advocated. Seven patients in the current series have survived. This experience plus a review of the literature indicate that long-term survival is possible with only a small amount of small bowel remaining. The initial procedure of choice is resection of the dead bowel and reconstitution of bowel continuity. Adjunctive procedures such as reversed segment or vagotomy and pyloroplasty should be reserved for the occasional patient who survives the initial operative procedure, but in whom adequate control of diarrhea and maintenance of nutrition cannot be accomplished by dietary programs. © 1969.