Short-term results of gastrectomy with Roux-en-Y or Billroth II anastomosis for peptic ulcer. A prospective comparative study

P. N M A Rieu, J. B M J Janson, I. Blemond, G. J A Offerhaus, H. J M Joosten, C. B H W Lamers

Research output: Contribution to journalArticle

Abstract

Since the Roux-en-Y anastomosis prevents the sequela of post-operative enterogastric reflux after gastrectomy, this approach has been advocated as the primary procedure in patients undergoing gastrectomy for peptic ulcer. We have prospectively followed for 2 years 22 patients, in whom gastrectomy was performed with, at random, either Roux-en-Y (n= 11) or Billroth II (n= 11) anastomosis. Two of the 11 patients who had received the Roux-en-Y procedure had anastomotic ulcers, leading to reresection in one of them. These two patients were found to have the highest values for basal and pentagastrin stimulated gastric acid output. After the Billroth II procedure a single patient had a small anastomotic ulcerative lesion. Apart from differences in intragastric bile acids (p <0.0001) and the gastritis activity score (p <0.01), no significant differences were found between the patients with Roux-en-Y and Billroth II anastomosis with respect to basal and pentagastrin- stimulated gastric acid secretion, basal, postprandial and bombesin-stimulated serum gastrin secretion, serum pepsinogen A and C concentrations, the serum pepsinogen A/C ratio, postprandial glucose, and for a modified Visick grading. From this small series we conclude that, as compared with the Billroth II-anastomosis, the Roux-en-Y procedure effectively prevents enterogastric reflux, and is associated with a higher gastritis activity score, but not with differences in gastric acid, gastrin, pepsinogens, or Visick grading. Furthermore, inadequate reduction of acid secretion in some patients after the Roux-en-Y procedure may lead to recurrent peptic ulcers.

Original languageEnglish (US)
Pages (from-to)22-26
Number of pages5
JournalHepato-Gastroenterology
Volume39
Issue number1
StatePublished - 1992
Externally publishedYes

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Gastroenterostomy
Gastrectomy
Peptic Ulcer
Prospective Studies
Gastric Acid
Pepsinogen C
Roux-en-Y Anastomosis
Pepsinogen A
Pentagastrin
Gastrins
Gastritis
Pepsinogens
Serum
Bombesin
Bile Acids and Salts
Ulcer
Glucose
Acids

Keywords

  • Bileacids
  • Billroth II
  • Gastricacid
  • Gastrin
  • Partial gastrectomy
  • Pepsinogen
  • Roux-en-Y
  • Stomal ulcer

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Rieu, P. N. M. A., Janson, J. B. M. J., Blemond, I., Offerhaus, G. J. A., Joosten, H. J. M., & Lamers, C. B. H. W. (1992). Short-term results of gastrectomy with Roux-en-Y or Billroth II anastomosis for peptic ulcer. A prospective comparative study. Hepato-Gastroenterology, 39(1), 22-26.

Short-term results of gastrectomy with Roux-en-Y or Billroth II anastomosis for peptic ulcer. A prospective comparative study. / Rieu, P. N M A; Janson, J. B M J; Blemond, I.; Offerhaus, G. J A; Joosten, H. J M; Lamers, C. B H W.

In: Hepato-Gastroenterology, Vol. 39, No. 1, 1992, p. 22-26.

Research output: Contribution to journalArticle

Rieu, PNMA, Janson, JBMJ, Blemond, I, Offerhaus, GJA, Joosten, HJM & Lamers, CBHW 1992, 'Short-term results of gastrectomy with Roux-en-Y or Billroth II anastomosis for peptic ulcer. A prospective comparative study', Hepato-Gastroenterology, vol. 39, no. 1, pp. 22-26.
Rieu, P. N M A ; Janson, J. B M J ; Blemond, I. ; Offerhaus, G. J A ; Joosten, H. J M ; Lamers, C. B H W. / Short-term results of gastrectomy with Roux-en-Y or Billroth II anastomosis for peptic ulcer. A prospective comparative study. In: Hepato-Gastroenterology. 1992 ; Vol. 39, No. 1. pp. 22-26.
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