[Diagnosis and treatment of afferent loop syndrome]

In the period from 1981 to 1990, 43 patients were treated for the afferent loop syndrome. Their ages ranged from 20 to 76 years. Hofmeister-Finsterer gastric resection was the most frequent (81.40%) primary operation, in four patients (9.30%), primary resection was performed with anterocolonic anastomosis on a long loop after Braun. In two patients (4.65%) the syndrome had developed after Roux resection. In 12 patients (27.90%), the afferent loop syndrome was combined with the dumping syndrome, and in 24 (55.81%) with peptic ulcer of the gastrojejunoanastomosis, which along with other causes was the etiologicl al factor of the syndrome due to stenosis and deformity of the intestine. The afferent loop syndrome was classified into two degrees of severity according to the need for operative treatment and the presence of other diseases, "postgastroectomy syndromes", for which surgery was also needed. There were 8 patients (18.6%) with a mild afferent loop syndrome and 35 (81.40%) with the severe form. Patients of the last-named group were subjected to various reconstructive operations. Reconstruction of the anastomosis after Billroth-I is the method of choice in the afferent loop syndrome, particularly in patients with concurrent dumping syndrome (they were treated also by reconstructive gastrojejunoduodenoplasty). In patients with concomitant peptic ulcer of the anastomosis the creation of Braun anastomosis and resection after Roux are sometimes ineffective.