[Endoscopic biopsy study results of stomach stumps following Billroth II resection]

The results of gastroscopico-bioptical examinations of 121 unselected patients on an average 18 years after the Billroth-II-resection on account of peptic ulcers were apart from 6 carcinomas (5%) conspicuously high incidences of polyps (17%), islets of lipids (13.2%) and dysplasias (19%). Manifold biopsies from anastomosis and middle of the stump showed an approximate histomorphological uniformity only in 50--60%, whereby atrophic changes at the anastomosis dominated in 29% of the cases. As in the non-operated stomach, therefore, also in the stump stomach the gastritic degrees of severity are unequally distributed. An atrophic gastritis was present altogether only in 50% of the patients so that postoperatively a regularly accelerated transition to the diffuse atrophy of the mucous membrane is not to be expected. The importance of the chronic atrophic gastritis with intestinal metaplasia as well as of the dysplasias--particularly in the Billroth II stump of the stomach--as a precancerous lesion or condition is discussed in connection with the increased risk of a carcinoma after resection of the stomach. Beginning with the 10th year after the Billroth-II-operation the dispensary care must be enlarged by long-term, continuous gastroscopico-bioptical controls, in which cases the early recognition of precanceroses and carcinomas is in the foreground.