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Postgastrectomy Retention: Treatment by Second Gastroenterostomy

Postgastrectomy Retention: Treatment by Second Gastroenterostomy Abstract In view of the fact that the logical treatment of stomach obstruction after gastrectomy is based on its pathogenesis, a brief review of the causative factors of this not infrequent complication seems justified. Malfunction of the stoma may be of functional or organic origin. There is a lack of agreement about the character of functional disturbances. One school of thought1,2 voices the belief that a spastic contraction of the efferent loop may be due to "pseudovagotomy," created by cessation of the sympathetic function. Conversely, another group3 holds the view that postoperative gastric atony may play a considerable part in retarded emptying of the stomach. Ravdin4 pointed out that a low colloid osmotic pressure, due to hypoproteinemia, may give rise to edema of the suture line and that the coincidental dehydration may mask the serum protein deficiency. An organic obstruction may be created by one of the numerous References 1. Reischauer, F.: Zur Frage der postoperativen Passagestörungen des Magens , Beitr. klin. Chir. 144:639, 1928. 2. Golden, R.: Functional Obstruction of Efferent Loop of Jejunum Following Partial Gastrectomy , J. A. M. A. 148:721, 1952.Crossref 3. Brandberg, R.: Obstruction Following Gastric Resection and Gastroenterostomy , Acta Chir. scandinav. 92:37, 1945. 4. Ravdin, I. S.: Factors Involved in the Retardation of Gastric Emptying After Gastric Operations , Pennsylvania M. J. 41:695, 1938. 5. Colp, R., and Weinstein, V.: Postoperative Complications Following Subtotal Gastrectomy for Peptic Ulcer , Surg. Clin. N. Amer. 35:383, 1955. 6. Nissen, R.: Local Causes of Mortality and Early Morbidity in Gastroduodenal Resection for Peptic Ulcer , J. Internat. Coll. Surgeons 13:549, 1950. 7. Shackelford, R. T.: Surgery of the Alimentary Tract , Philadelphia, W. R. Saunders Company, 1955, Vol. 1, p. 500. 8. Warren, K. W.: Acute Pancreatitis and Pancreatic Injuries Following Subtotal Gastrectomy , Surgery 29:643, 1951. 9. Lahey, F. H., and Marshall, S. F.: The Surgical Treatment of Peptic Ulcer , New England J. Med. 246:115, 1952.Crossref 10. Narat, J. K., and Manelli, L. A.: Postgastrectomy Stricture of the Efferent Loop and Its Treatment , A. M. A. Arch. Surg. 66:192, 1953.Crossref 11. Perman, E.: Surgical Treatment of Gastric and Duodenal Ulcers , Acta chir. Scandinav. ( (Supp. 38) ) 77:1, 1935. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Postgastrectomy Retention: Treatment by Second Gastroenterostomy

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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280100111019
Publisher site
See Article on Publisher Site

Abstract

Abstract In view of the fact that the logical treatment of stomach obstruction after gastrectomy is based on its pathogenesis, a brief review of the causative factors of this not infrequent complication seems justified. Malfunction of the stoma may be of functional or organic origin. There is a lack of agreement about the character of functional disturbances. One school of thought1,2 voices the belief that a spastic contraction of the efferent loop may be due to "pseudovagotomy," created by cessation of the sympathetic function. Conversely, another group3 holds the view that postoperative gastric atony may play a considerable part in retarded emptying of the stomach. Ravdin4 pointed out that a low colloid osmotic pressure, due to hypoproteinemia, may give rise to edema of the suture line and that the coincidental dehydration may mask the serum protein deficiency. An organic obstruction may be created by one of the numerous References 1. Reischauer, F.: Zur Frage der postoperativen Passagestörungen des Magens , Beitr. klin. Chir. 144:639, 1928. 2. Golden, R.: Functional Obstruction of Efferent Loop of Jejunum Following Partial Gastrectomy , J. A. M. A. 148:721, 1952.Crossref 3. Brandberg, R.: Obstruction Following Gastric Resection and Gastroenterostomy , Acta Chir. scandinav. 92:37, 1945. 4. Ravdin, I. S.: Factors Involved in the Retardation of Gastric Emptying After Gastric Operations , Pennsylvania M. J. 41:695, 1938. 5. Colp, R., and Weinstein, V.: Postoperative Complications Following Subtotal Gastrectomy for Peptic Ulcer , Surg. Clin. N. Amer. 35:383, 1955. 6. Nissen, R.: Local Causes of Mortality and Early Morbidity in Gastroduodenal Resection for Peptic Ulcer , J. Internat. Coll. Surgeons 13:549, 1950. 7. Shackelford, R. T.: Surgery of the Alimentary Tract , Philadelphia, W. R. Saunders Company, 1955, Vol. 1, p. 500. 8. Warren, K. W.: Acute Pancreatitis and Pancreatic Injuries Following Subtotal Gastrectomy , Surgery 29:643, 1951. 9. Lahey, F. H., and Marshall, S. F.: The Surgical Treatment of Peptic Ulcer , New England J. Med. 246:115, 1952.Crossref 10. Narat, J. K., and Manelli, L. A.: Postgastrectomy Stricture of the Efferent Loop and Its Treatment , A. M. A. Arch. Surg. 66:192, 1953.Crossref 11. Perman, E.: Surgical Treatment of Gastric and Duodenal Ulcers , Acta chir. Scandinav. ( (Supp. 38) ) 77:1, 1935.

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A.M.A. Archives Surgery – American Medical Association

Published: Apr 1, 1957

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