Physiological gastrectomy is:

Physiological Gastrectomy is:

A. Ligation of all major arteries
B. Antrectomy
C. Upper 1/3 of stoma resected
D. Ligation of 4 out of 5 arteries

Answer is A. Ligation of all major arteries.

The stomach has five major arterial sources, namely the right and left gastric arteries, left and right gastroepiploic arteries and short gastric artery and numerous minor and collateral sources.

• Schein and Saadia showed that complete gastric wall vascular filling can be achieved in cadavers with only one patent major artery. 
• Another person, Somervell found he could achieve gastric necrosis in animal models after ligation of the right and left gastric arteries, right and left gastroepiploic arteries, and 80% of collaterals. 
• Babkin and colleagues noted that ligating most of the arterial supply to dogs' stomachs did not result in ischemis; however, both venous and arterial occlusion produced infarction in every case. 

 In the light of above findings, ligate all major arteries would constitute physiological gastrectomy.

 Definition: Physiological gastrectomy is an operation in which ligature of the arteries of the stomach is used to achieve relief from hyperacidity and to prevent recurrent ulceration after gastro-enterostomy - T.H. Somervell, British Journal of Surgery