[Endoscopic evaluation of various methods of anastomosis after gastrectomy]

Resection of the stomach is still the principal method for surgical management of gastric and duodenal ulcer. The functional condition of the anastomosis depends on the method used. The authors conducted comparative endoscopic evaluation of anastomoses formed after Hofmeister-Finsterer, Billroth I, Andreo and Vitebsky according to the following criteria: shape and diameter; contractile and obturator function; gastrointestinal reflux; morphological changes in the zone of the anastomosis and the gastric stump. The authors analyse their own material concerning fibrogastroscopy in 168 patients after gastric resection, the anastomosis was established after Hofmeister-Finsterer in 93 of them after Vitebsky in 46, after Billroth I in 21, and after Andreo in 8. Vitebsky's modification of Billroth II anastomosis and Andreo's modification of Billroth I anastomosis possess the best functional capacities. Billroth I and Billroth II gastroenterostomy in Hofmeister-Finsterer's modification do not possess contractile and obturator property, which promotes reflux of bile into the gastric stump and the development of reflux gastritis and other complicating factors.