Partial gastrectomy for peptic ulcer by the Krønlein method. An outpatient follow-up study 12 years later with particular reference to endoscopy with biopsy and brush cytology and to clinical-chemical and radiological results
Skarstein, A.; Segadal, E.; Halvorsen, J.F.; Lehmann, V.; Skaar, R.
Scandinavian Journal of Gastroenterology. Supplement 64: 9-18
1980
ISSN/ISBN: 0085-5928 PMID: 6939116 Document Number: 168465
Forty-six patients were studied 12 yr after partial gastrectomy for peptic ulcer. They were all subjected to a standard Billroth II type operation as described by Kronlein, with emphasis laid upon the transverse position of the gastrojejunostomy. The clinical examination was supplemented by an outpatient gastroscopy with photography, biopsy and brush cytology and by a series of blood analyses and X-ray of the gastric remnant. The general finding on gastroscopy was a slightly injected mucosa with flattened folds near the anastomosis, no or slight bile reflux. The cytological examination revealed metaplasia in 7.5-15% of the specimens, no sign of dysplasia or carcinoma. Biopsy showed severe atrophic gastritis in 0-13% of the specimens, slight to moderate in 58-96%; no signs of cellular atypia or irregular arrangements. Judged by the results of blood analyses a deficiency in Fe, Vitamin B12 or both, was demonstrated in about 25% of the patients and of these more than 50% were anemic. X-ray examination showed that 70% of the patients had a gastric remnant emptying time of 10-20 min. A transverse position of the anastomosis could be demonstrated in about 67%. The necessity of a close follow-up of these patients is stressed.