[Experimental study on the pathogenesis of anastomotic ulcers (author's transl)]

Various forms of operative duodenal exclusion with or without duodenogastric reflux were performed on 54 male Wistar rats. It was demonstrated that after duodenal exclusion with reflux peptic ulcers regularly occur at the site of anastomosis. Continuous reflux of bile and pancreatic secretion is the decisive factor in the development of ulcer at the anastomotic border between stomach and jejunum. Stasis in the excluded duodenum (syndrome of the afferent loop) promotes the ulcerogenic reflux effect. If there is no pylorus, reflux and stasis are potentiated to the highest incidence of ulcer (more than 90%). These results indicate that operations with duodenal exclusion and reflux (Billroth II) should be discontinued.