system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 68-year-old woman has been diagnosed with a benign ulcer on the greater curvature of her stomach, 5 cm proximal to the antrum. After 3 months of standard medical therapy, she continues to have guaiac positive stool, anemia, and abdominal pain with failure of the ulcer to heal. Biopsies of the gastric ulcer have not identified a malignancy. The next step in management is which of the following?
assistant
The correct answer is  Vagotomy with a gastric drainage procedure is less satisfactory in the treatment of primary gastric ulcer. Treatment of a gastric ulcer may include Paial gastrectomy with a gastro-duodenal anastomosis (Billroth I). Vagotomy is not necessary because gastric ulcers are usually not associated with acid hypersecretion. A gastric ulcer that fails to heal despite medical therapy should be excised