Gastrointestinal anastomoses and carcinoma in the operated on stomach
Dahm, K.; Eichen, R.; Werner, B.; Kozuschek, W.
Der Chirurg; Zeitschrift für Alle Gebiete der Operativen Medizen 47(9): 494-495
1976
ISSN/ISBN: 0009-4722 PMID: 991695 Document Number: 108237
This study examines the question of which type of gastroenteral anastomosis is predisposed to carcinoma of the gastric stump. Evaluation of operative or autopsy reports of 72 patients with carcinomas of the gastric stump following ulcer resection was undertaken. The interval after resection for ulcer was on the average 23 years. In 69 cases a Billroth II resection with retrocolic anastomosis (Polya type) had been performed; 7 patients had a Billroth II resection with enteroanastomosis (Braun's type); only 3 cases of Billroth I resection were found in the whole collective. From the results it may be concluded that carcinoma of the gastric stump develops predominantly in the remaining stomach following Billroth II resection with retrocolic anastomosis (without Braun's enteroanastomosis). When retrocolic anastomosis is performed, the duodenogastric reflux definitely passes through via atrophic gastritis to the development of a stump carcinoma. However, when Billroth I resection or Billroth II resection with enteroanastomosis is performed, the duodenogastric reflux is low or is quantitatively derived into the jejunum.