[Morphology and pathophysiology of Billroth I gastro-duodenostomy (author's transl)]

Endoscopic and radiological studies were undertaken in 97 patients who had had a partial gastric resection with gastro-duodenostomy (Billroth I) one to seven years previously. Acid secretion was also analyzed after injection of pentagastrin. The most frequent mucosal changes seen at endoscopy were erosion in the residual stomach, with inflammatory granulation in the region of the anastomosis. Recurrent ulcers were seen in 3%. Acid secretion was reduced by 87% from its pre-operative level. The amount of residual secretion depended on the length of the greater curvature in the residual stomach. Radiological studies revealed functional changes indicating that there is a motility pattern in the residual stomach and a pseudopyloric function at the anastomosis which makes co-ordinated emptying possible.