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.
Department of Surgery, General Hospital, Malmö, Sweden.
U H
UH
Haglund
R L
RL
Jansson
J G
JG
Lindhagen
L R
LR
Lundell
E G
EG
Svartholm
L C
LC
Olbe
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