{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:43:00Z","timestamp":1775572980353,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"776","license":[{"start":{"date-parts":[[1990,6,1]],"date-time":"1990-06-01T00:00:00Z","timestamp":644198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1990,6,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Prior to 1960 a Polya gastrectomy was the most frequent operation for duodenal ulcer. The majority of these patients now have reached the age of sixty or older. A prospective longitudinal study of a cohort of patients who underwent gastrectomy between 1955 and 1960 was undertaken. Twenty five to thirty years later the study has revealed the extent of the nutritional problems that may arise with the passage of time and shows that these numerically far outweigh the mechanical post-gastrectomy syndromes and weight loss which tended to dominate the earlier post-gastrectomy scene.<\/jats:p><jats:p>By the end of the first decade, iron deficiency was the commonest nutritional problem. Vitamin B12 deficiency assumed more importance in the second decade. During the third decade both reached equal prevalence, being found in some 90% of the female and 70% of the male residual population. Vitamin D deficiency and early osteomalacia was a lesser problem, reaching its climax in the second decade. Evidence suggested a high incidence of osteoporosis and this requires further investigation. Overall, women fared worse than men with a higher and earlier incidence of iron deficiency, particularly in the pre-menopausal group.<\/jats:p><jats:p>This study emphasizes the increasing need for regular screening of post-gastrectomy patients to detect early iron, vitamin B12 and vitamin D deficiencies as patients grow older.<\/jats:p>","DOI":"10.1136\/pgmj.66.776.450","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:01:03Z","timestamp":1230584463000},"page":"450-456","source":"Crossref","is-referenced-by-count":54,"title":["A gastrectomy population: 25\u201330 years on"],"prefix":"10.1093","volume":"66","author":[{"given":"F I","family":"Tovey","sequence":"first","affiliation":[{"name":"Department of Surgery, University College London, The Rayne Institute , 5 University Street, London WC1E 6JJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J E","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Department of Surgery, University College London, The Rayne Institute , 5 University Street, London WC1E 6JJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M R","family":"Lewin","sequence":"additional","affiliation":[{"name":"Department of Surgery, University College London, The Rayne Institute , 5 University Street, London WC1E 6JJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1990,6,1]]},"reference":[{"issue":"16","key":"ref_1","first-page":"189","article-title":"A new weight for height standard based on British anthropometric data","volume":"1962","author":"Kemsley, W.F.F.; Billewicz, W.Z.; Thomson, A.M.","unstructured":"Kemsley, W.F.F., Billewicz, W.Z. & Thomson, A.M. A new weight for height standard based on British anthropometric data. Br J Preventive Soc Med 1962, 16: 189-195.","journal-title":"Br J Preventive Soc Med"},{"issue":"10","key":"ref_2","first-page":"754","article-title":"Estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker","volume":"1969","author":"Lee, M.F.; Temperley, J.M.; Dick, M.","unstructured":"Lee, M.F., Temperley, J.M. & Dick, M. Estimation of faecal fat excretion using cuprous thiocyanate as a continuous marker. Gut 1969, 10: 754-759.","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/S0140-6736(80)91406-3","article-title":"Anaemia after partial gastrectomy: a neglected curable condition","volume":"i:","author":"Tovey, F.I.; Clark, C.G.","year":"1980","unstructured":"Tovey, F.I. & Clark, C.G. Anaemia after partial gastrectomy: a neglected curable condition. Lancet 1980, i: 956-958.","journal-title":"Lancet"},{"key":"ref_4","first-page":"35","article-title":"Anaemia in old age following partial gastrectomy in middle age: a neglected problem","volume":"1","author":"Clark, C.G.; Tovey, F.I.","year":"1982","unstructured":"Clark, C.G. & Tovey, F.I. Anaemia in old age following partial gastrectomy in middle age: a neglected problem. Geriatr Med Today 1982, 1: 35-39.","journal-title":"Geriatr Med Today"},{"issue":"39","key":"ref_5","first-page":"439","article-title":"Post-gastrectomy nutrition: methods of outpatient screening for early osteomalacia","volume":"1985","author":"Tovey, F.I.; Karamanolis, D.G.; Godfrey, J.E.; Clark, C.G.","unstructured":"Tovey, F.I., Karamanolis, D.G., Godfrey, J.E. & Clark, C.G. Post-gastrectomy nutrition: methods of outpatient screening for early osteomalacia. Hum Nutr Clin Nutri 1985, 39c: 439-446.","journal-title":"Hum Nutr Clin Nutri"},{"key":"ref_6","first-page":"817","article-title":"Screening for early post-gastrectomy osteomalacia. (A therapeutic trial of calcium and vitamin D)","volume":"231","author":"Tovey, F.I.; Karamanolis, D.G.; Godfrey, J.E.; Clark, C.G.","year":"1987","unstructured":"Tovey, F.I., Karamanolis, D.G., Godfrey, J.E. & Clark, C.G. Screening for early post-gastrectomy osteomalacia. (A therapeutic trial of calcium and vitamin D). Practitioner 1987, 231: 817-822.","journal-title":"Practitioner"},{"key":"ref_7","first-page":"77","article-title":"Leading article. Osteomalacia after gastrectomy","volume":"i:","year":"1986","unstructured":"Leading article. Osteomalacia after gastrectomy. Lancet 1986, i: 77-78.","journal-title":"Lancet"},{"key":"ref_8","first-page":"1154","article-title":"Pattern of development and loss of bone with age","volume":"ii:","author":"Exton-Smith, A.N.; Millard, P.H.; Payne, P.R.; Wheeler, E.F.","unstructured":"Exton-Smith, A.N., Millard, P.H., Payne, P.R. & Wheeler, E.F. Pattern of development and loss of bone with age. Lancet 1969, ii: 1154-1157.","journal-title":"Lancet 1969"},{"issue":"5","key":"ref_9","first-page":"68","article-title":"Post-gastrectomy nutritional deficiencies: the need for vigilance increases with age","volume":"1986","author":"Tovey, F.I.; Godfrey, J.E.; Clark, C.G.","unstructured":"Tovey, F.I., Godfrey, J.E. & Clark, C.G. Post-gastrectomy nutritional deficiencies: the need for vigilance increases with age. Geriatr Med Today 1986, 5: 68-77.","journal-title":"Geriatr Med Today"},{"issue":"8","key":"ref_10","first-page":"293","article-title":"Twenty-five years after Billroth II gastrectomy for duodenal ulcer","volume":"1984","author":"Fischer, A.B.","unstructured":"Fischer, A.B. Twenty-five years after Billroth II gastrectomy for duodenal ulcer. World J Surg 1984, 8: 293-302.","journal-title":"World J Surg"},{"issue":"33","key":"ref_11","first-page":"319","article-title":"The long-term results following Billroth II resection for duodenal ulcer","volume":"1986","author":"Fischer, A.B.","unstructured":"Fischer, A.B. The long-term results following Billroth II resection for duodenal ulcer. Dan Med Bull 1986, 33: 319-335.","journal-title":"Dan Med Bull"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0300-5089(21)00039-0","article-title":"The long-term results ofpeptic ulcer surgery","volume":"2","author":"Small, W.P.","year":"1973","unstructured":"Small, W.P. The long-term results ofpeptic ulcer surgery. Clin Gastroenterol 1973, 2: 427-445.","journal-title":"Clin Gastroenterol"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1007\/BF01073077","article-title":"Serum ferritin and body iron ferritin after gastric operations","volume":"22","author":"Lloyd, D.A.; Valberg, L.S.","year":"1977","unstructured":"Lloyd, D.A. & Valberg, L.S. Serum ferritin and body iron ferritin after gastric operations. Am J Dig Dis 1977, 22: 598-604.","journal-title":"Am J Dig Dis"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1742-1241.1977.tb07386.x","article-title":"Vitamin B12 deficiency following Polya gastrectomy. A long-term followup","volume":"31","author":"Buxton, R.A.; Collins, C.D.; Phillips, M.J.","year":"1977","unstructured":"Buxton, R.A., Collins, C.D. & Phillips, M.J. Vitamin B12 deficiency following Polya gastrectomy. A long-term followup. Br J Clin Pract 1977, 31: 69-72.","journal-title":"Br J Clin Pract"},{"issue":"31","key":"ref_15","first-page":"77","article-title":"Changes in the blood after partial gastrectomy with special reference to vitamin B12, serum B12, haemoglobin, serum iron and bone marrow","volume":"1962","author":"Deller, D.J.; Witts, L.J.","unstructured":"Deller, D.J. & Witts, L.J. Changes in the blood after partial gastrectomy with special reference to vitamin B12, serum B12, haemoglobin, serum iron and bone marrow. Q J Med 1962, 31: 77-78.","journal-title":"Q J Med"},{"key":"ref_16","first-page":"1085","article-title":"Search for osteomalacia in 1,228 patients after gastrectomy and other operations on the stomach","volume":"ii:","author":"Morgan, D.B.; Paterson, C.R.; Woods, C.G.; Pulvertaft, C.N.; Fourman, P.","year":"1965","unstructured":"Morgan, D.B., Paterson, C.R., Woods, C.G., Pulvertaft, C.N. & Fourman, P. Search for osteomalacia in 1,228 patients after gastrectomy and other operations on the stomach. Lancet 1965, ii: 1085-1089.","journal-title":"Lancet"},{"key":"ref_17","first-page":"161","article-title":"Effects of vagotomy on bone metabolism","author":"Morgan, D.B.; Pulvertaft, C.N.","year":"1969","unstructured":"Morgan, D.B. & Pulvertaft, C.N. Effects of vagotomy on bone metabolism. In: Williams, J.A. & Cox, A.G. (eds) After Vagotomy: Butterworths, London, 1969, pp 161-171."},{"issue":"5","key":"ref_18","first-page":"218","article-title":"Metabolic effects of partial gastrectomy with special reference to calcium and folic acid. Part 1. Changes in calcium metabolism and the bones","volume":"1964","author":"Deller, D.J.; Begley, M.D.; Edwards, R.G.; Addison, M.","unstructured":"Deller, D.J., Begley, M.D., Edwards, R.G. & Addison, M. Metabolic effects of partial gastrectomy with special reference to calcium and folic acid. Part 1. Changes in calcium metabolism and the bones. Gut 1964, 5: 218-225.","journal-title":"Gut"},{"issue":"150","key":"ref_19","first-page":"485","article-title":"Long-term follow-up after Billroth I and II partial gastrectomy","volume":"1984","author":"Paakonen, M.; Alhava, E.M.; Karjalainen, P.; Korhonen, R.; Savolainen, K.; Syrjanen, K.","unstructured":"Paakonen, M., Alhava, E.M., Karjalainen, P., Korhonen, R., Savolainen, K. & Syrjanen, K. Long-term follow-up after Billroth I and II partial gastrectomy. Acta Chir Scand 1984, 150: 485-488.","journal-title":"Acta Chir Scand"},{"issue":"9","key":"ref_20","first-page":"576","article-title":"Post-gastrectomy malnutrition","volume":"1968","author":"Hillman, H.S.","unstructured":"Hillman, H.S. Post-gastrectomy malnutrition. Gut 1968, 9: 576-584.","journal-title":"Gut"},{"key":"ref_21","first-page":"1137","article-title":"Sequelae of radical gastric resections","volume":"i:","author":"Brain, R.H.F.; Stammers, F.A.R.","unstructured":"Brain, R.H.F. & Stammers, F.A.R. Sequelae of radical gastric resections. Lancet 1951, i: 1137-1140.","journal-title":"Lancet 1951"},{"issue":"29","key":"ref_22","first-page":"300","article-title":"The effect of gastrectomy on pancreatic secretion in man","volume":"1961","author":"Butler, Ti","unstructured":"Butler, T.i. The effect of gastrectomy on pancreatic secretion in man. Ann R Coil Surg Engl 1961, 29: 300-327.","journal-title":"Ann R Coil Surg Engl"},{"issue":"191","key":"ref_23","first-page":"142","article-title":"Results ofthe surgical treatment ofpeptic ulcer by partial gastrectomy according to Billroth I and II methods. A clinical study based on 1,256 operated cases","volume":"1954","author":"Wallensten, S.","unstructured":"Wallensten, S. Results ofthe surgical treatment ofpeptic ulcer by partial gastrectomy according to Billroth I and II methods. A clinical study based on 1,256 operated cases. Acta Chir Scand 1954, 191 (Suppl): 142-147.","journal-title":"Acta Chir Scand"},{"key":"ref_24","first-page":"93","article-title":"Comparison of different operations","volume-title":"After Vagotomy, Butterworths","author":"Golligher, J.C.; Pulvertaft, C.N.","year":"1966","unstructured":"Golligher, J.C. & Pulvertaft, C.N. Comparison of different operations: In: Williams, J.A. & Cox, A.G. (eds) After Vagotomy, Butterworths, London, 1966, pp.93-118."},{"key":"ref_25","first-page":"151","article-title":"A prospective study of the immediate and long-term results of standardised Polya gastrectomy","volume":"8","author":"McKeown, K.C.","year":"1967","unstructured":"McKeown, K.C. A prospective study of the immediate and long-term results of standardised Polya gastrectomy. Gut 1967, 8: 151-165.","journal-title":"Gut"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/66\/776\/450\/50077468\/postgradmedj-66-450.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/66\/776\/450\/50077468\/postgradmedj-66-450.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T06:36:23Z","timestamp":1684823783000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/66\/776\/450\/7062058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,6,1]]},"references-count":25,"journal-issue":{"issue":"776","published-online":{"date-parts":[[1990,6,1]]},"published-print":{"date-parts":[[1990,6,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.66.776.450","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1990,6]]},"published":{"date-parts":[[1990,6,1]]}}}