The rauonale for practice gmdehnes has been elucidated It is hoped that these guldehnes will result in changes in chnlcal care Perhaps the origin of these guldehnes may be a cnucal factor m whether they become widely accepted. Our purpose in developing guldehnes for gastrolntesunal surgical disorders is to promulgate reformation that is needed to evaluate patients with diseases that require surgery and to provide mformatlon concerning expected outcomes following specific operattve procedures As pracuce patterns and technology evolve, these guldehnes will need to be changed accordingly.