NONFUNCTIONING or malfunctioning anastomosis after gastroenterostomy or subtotal gastric resection is a relatively frequent postoperative complication, which may or may not necessitate further surgical intervention. Eastman and Cole1 encountered 7 cases of postoperative obstruction in a series of 191 gastrectomies. In a series of 100 cases reported by Gray and Sharpe2 in which posterior gastroenterostomy had been performed for duodenal ulcer, the incidence of gastric retention was 35%. Certain changes in the technique of operation and of postoperative care reduced this complication in another series of 100 cases to 19%. Serious retention was recorded in 24% in the first series and in 13% in the second group.
A multitude of factors may be responsible for postoperative gastric retention. According to location, they may be divided into three groups:
1. Those affecting the proximal or afferent limb. When the resection has been unusually high, a kink may form where