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August 1971

Gastrojejunostomy: An Unsatisfactory Drainage Procedure for Vagotomy

Author Affiliations

Lexington, Ky
From the Department of Surgery, University of Kentucky Medical Center, Lexington.

Arch Surg. 1971;103(2):140-146. doi:10.1001/archsurg.1971.01350080056008

In a group of ten patients undergoing vagotomy and gastroenterostomy for duodenal ulcer, five proved and two suspected recurrent (marginal) ulcers were seen after eight years' follow-up. Since this was a much higher recurrence rate than that after pyloroplasty, a review of the literature on the reported efficacy of the two drainage techniques was undertaken. Following 1,657 pyloroplasties, the recurrence rate was 3.8%, whereas a 9.6% incidence was reported after 2,508 gastroenterostomies. The late complications and patient dissatisfaction were higher in the gastroenterostomy group. The afferent loop syndrome may be seen only in patients with a gastric-jejunal anastomosis. The single advantage for gastroenterostomy, namely that it avoids dissection in the area of maximum scarring, may be obviated by a side-to-side gastroduodenostomy which possesses all of the physiologic advantages of a pyloroplasty. It is concluded that gastrojejunostomy is the least satisfactory drainage procedure for a vagotomy.

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