This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Stomach & Duodenum, Subject name: Surgery
A 75-year-old man is admitted with epigastric pain, anemia, and weight loss. On upper gastrointestinal endoscopy, a large ulcer is found in the distal antrum. The biopsy report shows adenocarcinoma of the stomach. CAT scan of the liver shows no metastasis. You would recommend: 
Select and explain. 
A. Whipple procedure (pancreaticoduodenectomy), B. Vagotomy and antrectomy, C. Subtotal gastrectomy, D. Vagotomy and pyloroplasty with wedge resection of the ulcer
C: Subtotal gastrectomy
Answer: C: Subtotal gastrectomy 
Explanation: A subtotal gastrectomy with negative margins is appropriate treatment for gastric carcinoma. Vagotomy adds nothing as patients with gastric cancer are invariably achlorhydric. A Whipple procedure is done for pancreatic carcinoma. Total gastrectomy is rarely indicated for a distal gastric carcinoma.