[Results following reflux-free stomach resection with Roux-en-Y anastomosis in gastroduodenal ulcer]

The ulcer risk of Billroth-II-Y-Roux anastomosis, following distal two-third to three-quarter gastrectomy for complicated duodenal ulcer, ventricular ulcer, and pepto-jejunal ulcer was checked in 29 of 31 patients after surgery. (One patient had died after the operation and one rejected follow-up check for absence of complaints.) The same group of 29 patients underwent postoperative clinical examinations 1.6 years later, with additional nucleomedical, endoscopico-bioptic, and histological tests applied to 27 and additional secretion analysis to twelve of them. Twenty-eight patients were rechecked by Visick grading, approximately 3.9 years, following surgery. All 29 or 28 patients were clinically found to be in keeping with Visick I and II (100 per cent). Nucleomedical and endoscopic examinations did not reveal reflux in any of the 27 patients thus tested, and no recurrent ulcer was endoscopically recorded. Three patients refused to undergo endoscopy for absence of complaints. The time span of postoperative follow-up checks was as short as 1.6 years on average (between ten months and 4.5 years). Only trend information could, therefore, be derived from the histomorphological findings regarding minor mucosal changes, as compared to conventional techniques of resection. Reflux-free Y-Roux repair may be recommended as a mucosa-productive technique without increased ulcer risk, provided that gastrectomy is performed about 2 cm to 4 cm distal to the cardia.