Subtotal gastrectomy and gastroduodenal end-to-side anastomosis for treating duodenal bulb macroulcer / 中国现代普通外科进展

ABSTRACT

To find an ideal surgical therapy for duodenal bulb macroulcer which can replace the conventional Billroth Ⅱ procedure and reduce the rate of long term complication.Methods:Forty nine patients with duodental bulb macroulcer were operated by subtotal gastrectomy and gastroduodenal end to side anastomosis.Results:One patient bleeded on the seventh operative day,because of the blood vessel's ligature sheded at the submucous of the lesser curvature of stomach,the others recoveried satisfactoryly.Bilirubin assay in the gastric juice,was negative and pH scale rose from 2.7?0 5 to 5.2?0 4. Barium meal examination showed that the"Reproduced Pyloruses"had satisfactory function of evacuation control.Conclusion: This procedure accords with normal physiolagical channel.It has satisfactory function of evacuation control and anti reflux.There is no afferent influent loop syndrome or posterior anastomotic stoma space.It is easily operated,safy and reliably.