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Acid corrosive injury in patients with a history of partial gastrectomy: outcome analysis
Jia-Ming Chang1, Ming-Ho Wu, Wu-Wei Lai
1Division of Thoracic Surgery, Department of Surgery, Medical College, National Cheng Kung University, Tainan, Taiwan.
Background:
Our purpose was to delineate the characteristics and outcome of acid-corrosive injury in patients with a history of gastric resection.
Material And Methods:
A total of 359 patients with a history of acid-corrosive injury were retrospectively reviewed. They were grouped based on past history with group 1 consisting of 8 patients with a history of gastric surgery (6 hemigastrectomies with Billroth II gastrojejunostomy, 2 partial gastrectomies with Billroth I gastroduodenostomy) and group 2 consisting of 351 patients without a history of previous gastric surgery. Clinical data, operative findings, treatment modalities and prognoses were compared.
Results:
Group 1 patients required significantly more emergency surgical interventions (p=0.016) and more frequent resection of alimentary necrosis (p=0.007). In the operative findings of those undergoing emergency laparotomy, group 1 had a slightly higher incidence of total gastric necrosis with or without perforation (p=0.388), and a higher incidence of jejunal resection (p=0.001). However, group 1 patients had a relatively lower operative mortality rate compared to group 2 patients (p=0.640).
Conclusion:
Acid-injured patients with a history of previous gastric surgery tended to have a higher incidence of mandatory emergency surgical exploration and resection of the alimentary tract. With early and prompt management, a good survival rate can still be anticipated.
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