Surgical management of ulcer disease.

Surgical management of patients who have acid peptic ulcers requires a firm understanding of the technical options and an even firmer grasp of the anatomic, physiologic, and pathophysiologic relationships of the organs involved. This is a constellation of problems in which the surgeon needs to be far more than a technician. The wealth of information discovered on this subject, from the clinical observations of William Beaumont to the discovery of complex cellular biology and hormonal signaling, is enough to occupy the study of several careers. Although patients who have acid peptic disorders have largely become the primary responsibility of physicians and specialists other than surgeons, when significant complications occur in these patients, it is the surgeon who is called upon to intervene.