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Twenty-five years after Billroth II gastrectomy for duodenal ulcer

World Journal of Surgery volume 8, pages 293–301 (1984)Cite this article

Abstract

One thousand twenty-five patients underwent a Billroth II resection for duodenal ulcer between 1948 and 1956. The operative mortality rate was 2.4%. At follow-up between 22 and 30 years later, 522 had died and 423 patients were traced. Recurrent ulcer appeared in 2.6% of the cases. Postgastrectomy symptoms occurred with the following frequency: dumping 10%, diarrhea 5%, vomiting 7%, and pain 4%. Anemia developed in 18%, hypoalbuminemia and hypocalcemia in 40 and 15%, respectively. Eleven percent had lost more than 10 kg in weight. Tuberculosis was found in 3% of the cases. While 90% of the patients were satisfied with the result, 10% were failures. The overall mortality rate was significantly increased because of suicide. Gastric carcinoma was the cause of death no more often than expected.

Résumé

De 1948 à 1956, 1 025 malades atteints d'ulcère duodénal ont subi une opération de Billroth II. La mortalité a été de 2,4%. Au cours de l'évolution de 22 à 30 ans après l'intervention, 522 opérés sont décédés et 423 ont été suivis. La fréquence de la récidive a été de 2,6%. Les symptômes après gastrectomie ont atteint les taux suivants: dumping 10%, diarrhée 5%, vomissements 7%, douleur 4%. L'anémie a été constatée dans 18% des cas, l'hypoalbuminémie dans 40% des cas et l'hypocalcémie dans 15% des cas, onze pour cent des opérés ont accusé une chute pondérale supérieure à 10 kg; 3% ont présenté une tuberculose. Au total 90% des malades se sont déclarés satisfaits de l'intervention, encore que certains opérés se soient suicidés, ce nombre intervenant dans la mortalité globale. La mortalité par cancer n'a pas dépassé le taux accusé par la population en général.

Resumen

En años anteriores la gastrectomía Billroth II fue un procedimiento operatorio de uso común en el tratamiento de la úlcera duodenal. Los promisorios resultados de la vagotomía con drenaje, vagotomía y antrectomía y, especialmente, la vagotomía de células parietales han reducido el rol de la resección de tipo Bilroth II. El propósito del presente estudio es describir los resultados a largo plazo en un grupo de pacientes sometidos a gastrectomía Billroth II por úlcera duodenal aproximadamente 25 años antes.

Entre 1948 y 1956, 1 025 pacientes consecutivos, 810 hombres y 190 mujeres, fueron sometidos a resección Billroth II por úlcera duodenal. La mortalidad operatoria fué de 2,4%. Durante el período de seguimiento entre 22 y 30 años, 522 pacientes habían muerto y 423 pacientes pudieron ser ubicados para seguimiento. Síntomas de post-gastrectomía fueron observados con la incidencia siguiente: “dumping” 10%, diarrea 5%, vómito 7% y dolor 4%. La anemia se presentó en el 18%, hipoalbuminemia e hipocalcemia en el 40% y en el 15% respectivamente. Se presentó tuberculosis en el 3% de los casos. El 90% de los pacientes se mostraron satisfechos con el resultado de la operación, pero el 10% restante indicó la falla del tratamiento. La mortalidad global resultó significativamente incrementada debido a una alta incidencia de suicidio. El carcinoma gástrico fue causa de muerte con una frecuencia no aumentada, o sea que no se encontró un mayor riesgo de muerte por carcinoma de esófago o del remanente gástrico.

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  1. Surgical Department I, Kommunehospitalet, Copenhagen, Denmark

    Anders B. Fischer M.D.

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Supported by grants from the Danish Medical Research Council (No. 512-8760) and “Købmand i Odense Johann & Hanne Weimann, født Seedorffs legat.”

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Fischer, A.B. Twenty-five years after Billroth II gastrectomy for duodenal ulcer. World J. Surg. 8, 293–301 (1984). https://doi.org/10.1007/BF01655056

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Keywords

  • Carcinoma
  • Mortality Rate
  • Tuberculosis
  • Anemia
  • Diarrhea