Primary Roux-Y gastrojejunostomy versus gastroduodenostomy after antrectomy and selective vagotomy.
One hundred twenty-one patients with prepyloric ulcer disease entered a randomized clinical trial comparing gastroduodenostomy with Roux-Y gastrojejunostomy after antrectomy and selective gastric vagotomy. The postoperative course and morbidity were quite similar in the two study groups, as was the postoperative infectious complication rate. Forty-four of the patients with a Billroth I reconstruction and 52 of those with a Roux-Y reconstruction were followed up with a clinical assessment at least 6 months after the operation. The postgastrectomy symptoms were quite frequent, but did not differ between the two study groups. Seventy-five percent of the patients with a Billroth I gastroduodenostomy had symptoms corresponding to Visick grades 1 and 2, compared with 81% of those with Roux-Y reconstruction. Although the latter procedure was very effective in preventing bile reflux to the gastric remnant, no difference was observed in the gastric emptying rate after the two operations.
Haglund
U H
UH
Department of Surgery, General Hospital, Malmö, Sweden.
Jansson
R L
RL
Lindhagen
J G
JG
Lundell
L R
LR
Svartholm
E G
EG
Olbe
L C
LC
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005763:Gastroenterostomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000209:etiology; D011183:Postoperative Complications; D011706:Pyloric Antrum / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D013276:Stomach Ulcer / Q000601:surgery; D013997:Time Factors; D014629:Vagotomy, Proximal Gastric