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July 1955

The Surgical Management of Postanastomotic and Postgastrectomy Malfunctions

Author Affiliations

Portland, Ore.
From the Department of Physiology, University of Oregon Medical School and the Emanuel Hospital.

AMA Arch Surg. 1955;71(1):95-108. doi:10.1001/archsurg.1955.01270130097016

Patients with a variety of minor or major postgastrectomy disturbances are most frequently designated as mild or severe dumpers. Theories regarding causation of such disturbances are most frequently based on a number and variety of manifestations ascribed to the precipitate evacuation of unprepared foodstuffs into the efferent jejunal loop (dumping). A searching review of the case histories of 33 patients personally subjected to corrective operations because of crippling postanastomotic and postgastrectomy side-effects with the analysis of results after surgery affords additional support to my previous contention that malfunctions other than those caused by dumping are rather frequent.* A number of such malfunctions can be either prevented or eventually rectified by definitive surgical techniques.

Issues involved in the causation of postanastomotic and postgastrectomy side-effects may be attributed to one of three separate mechanisms of malfunction: (1) Gastric pouch malfunction; (2) Dumping malfunction (efferent loop syndrome, Wells and Welbourn16); (3) Reflux

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