One of the most serious and distressing complications following surgical treatment for benign gastroduodenal ulcerations is the postoperative peptic ulcer. Jejunal ulcers following gastro-enterostomy have been reported frequently in the literature. It appears that no method of surgical procedure offers an absolute assurance against this much dreaded complication. In 1921, Denk1 reported six cases of definite peptic ulcers and eight doubtful cases following resection of the stomach. In 1925, Birgfeld2 reported fifty-three cases of jejunal ulcerations following the Billroth II method of resection of the stomach. In a summary of 13,000 resections of the stomach Starlinger3 reported 0.9 per cent recurrent ulcerations after the Billroth I method of resection, and 0.6 per cent jejunal ulcerations after the Billroth II method of resection.
There is a great deal of discussion in the literature concerning the etiology of this complication and the surgical methods most effective in its prevention.
STEINBERG ME, PROFFITT JC. THE ETIOLOGY OF POSTOPERATIVE PEPTIC ULCERS. Arch Surg. 1932;25(5):819-848. doi:10.1001/archsurg.1932.01160230002001