(c) In case of cancer invading the pylorus or pyloric end of the stomach or the duodenum incapable of radical removal, even though obstruction of the lumen be at the time incomplete, a gastrojejunostomy should be performed in order to prevent obstruction.
(d) Under similar conditions the short-circuiting operation may cause a great diminution in the size of the growth and in its activity, by putting it at rest.
(e) In hour-glass stomach due to cancer, where the growth is tending to produce a constriction in some part of the stomach and so leading to obstruction, a short-circuiting operation, whereby the proximal gastric cavity is connected to the jejunum, is capable of affording great relief and of retarding the growth of the tumour.
(f) In doubtful tumours at the pylorus, which are adherent to the liver, pancreas, and adjoining parts, and where the glands are involved, the performance of a gastrojejunostomy may prove entirely curative, as chronic ulcer with thickening may simulate cancer, and in that case will be cured by the rest secured by the operation.
(g) In haemorrhage from cancer or sarcoma of the stomach and when the growth cannot be removed, a gastroenterostomy may give great relief, and secure arrest of the bleeding.
(h) In persistent vomiting, either from retention or from irritation, a gastrojejunostomy may, if the disease is not boo far advanced, give great relief.
(i) In dilatation of the stomach dependent on pressure on the pylorus or duodenum from tumour of the pancreas, liver, or gall-bladder incapable of removal, a short-circuiting operation may be the means of giving great, though perhaps only temporary, relief.
(J) In certain cases where a cancer of the pyloric end of the stomach is removable and the glands are not too involved for a radical operation to be undertaken, but in which the patient is too feeble to bear the major operation, a gastro-jejunostomy may be performed, and after the patient has improved in the course of two or three weeks the gastrectomy may be carried out with great expedition, as the anastomosis has already been done and will save a considerable amount of time.
It is not necessary to mention the many indications for operation when the disease is simple, but I would remark that in all cases of chronic ulcer, whether producing obstruction or not, a gastrojejunostomy should be done as a curative operation for the ulcer and a preventative of cancer, to which chronic ulcer strongly predisposes.