Operative Innovation and Surgical Conservatism in Twentieth-Century Ulcer Surgery.

This article examines the evolution of surgical treatment for peptic ulcer disease in the United States during the first half of the twentieth century, highlighting the dynamic interplay between innovation and conservatism in operative practice. It traces how surgeons developed a canon of recognized operations—such as gastroenterostomy, partial gastrectomy, vagotomy, and the Roux-en-Y procedure—that were repeatedly modified, repurposed, and combined in modular configurations to address the persistent challenges of ulcer disease. The study emphasizes the durability of surgical operations once incorporated into professional discourse, noting that even disfavored techniques often persisted in niche uses or were revived in new contexts. Additionally, the article illustrates how ulcer surgery served as a testing ground for integrating physiological research and long-term outcome assessment into surgical decision-making, reflecting broader trends in twentieth-century surgical culture.