Disabilities Which May Follow the Peptic Ulcer Operation

Nc, Tanner

doi:10.1177/003591576605900419

Cited by 17 publications

(5 citation statements)

References 2 publications

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“…A reflux of bile into the stomach has also been observed in patients with gallbladder disease who have not undergone surgical treatment [20]. Presence of bile in the stomach is considered the cause of impairment to the gastric mucosa, as has been observed after surgery with gastric resection [21][22][23][24] and cholecystectomy [15,[25][26][27]. A greater frequency of biliary gastritis is also found in patients with cholelithiasis [15][16][17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…Presence of bile in the stomach is considered the cause of impairment to the gastric mucosa, as has been observed after surgery with gastric resection [21][22][23][24] and cholecystectomy [15,[25][26][27]. A greater frequency of biliary gastritis is also found in patients with cholelithiasis [15][16][17][18][19][20][21][22][23][24][25]. A gastric bile reflux is also involved in the pathogenesis of cancer of the stump in patients undergoing gastric resection [28][29][30][31][32][33], while diversion of bile significantly aExact p value and 95% confidence limits were obtained from the binomial distribution and were calculated for odds ratio > 1 only.…”

Section: Discussionmentioning

confidence: 99%

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Gallstones and gastric cancer: A matched case‐control study

et al. 1986

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A matched case‐control study was carried out in order to verify the association of gastric neoplasms and lithiasic biliary disease and to clarify the nature of this association in 157 patients operated on for gastric cancer. Each patient was examined for previous cholecystectomy. Concomitant cholelithiasis was identified by ultrasonographic and intraoperative exploration. A statistically significant incidence of concomitant cholelithiasis (p<0.01) was found in patients affected by cancer of the antropyloric region (27% versus 11.7%), in female patients (24.7% versus 11.8%, p<0.05), and in patients over the age of 65 (32.2% versus 17.2%, p<0.05). No association with cholecystectomy was revealed in any of the cases. On the basis of these results, it may be concluded that the association found is not to be attributed to well‐known risk factors that are common to both diseases or to alterations in the bile composition caused by lithiasic disease. It appears that cholecystectomy has a protective effect as regards the increased risk of gastric cancer in patients with cholelithiasis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gallstones and gastric cancer: A matched case‐control study

et al. 1986

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“…When the operation is being performed to prevent reflux of duodenal contents into the stomach or esophagus following anastomosis to an intact jejunal loop, the Roux-19 technique of Tanner [22] is convenient because it makes it unnecessary to dissect up to the stomach or esophagus. The afferent loop can be transected at a convenient point.…”

Section: Technical Variationsmentioning

confidence: 99%

Roux‐en‐Y

Kirk

1985

World j. surg.

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In Roux's modification of gastroenterostomy, the bowel is transected at the duodenojejunal junction. The proximal jejunum is united to the stomach. The duodenum is joined, end‐to‐side, into the jejunum at a distance from the gastrojejunostomy. Jejunal peristalsis is unidirectional, and contents entering its proximal end are removed and passed distally since jejunum is a transmitting—not a capacitance—part of the intestine. The loop can be used to drain away contents and also acts as a one‐way valve, preventing reflux. A single segment of intestine can be extended much farther than an intact loop, while retaining an adequate blood supply. Originally used to prevent intragastric bile reflux, the technique has been exploited to allow esophagojejunal anastomosis and drainage of the biliary and pancreatic ducts. The ability of a Roux‐en‐Y loop of jejunum to remove and pass on contents makes it a valuable means of draining cysts and fistulas. Preparing a Roux‐en‐Y segment demands careful preliminary assessment of the vascular supply to the upper jejunum since the pattern is inconstant. The technique of dividing the arterial and venous arcades to increase the reach of the jejunal segment is described, together with some of the more frequently used modifications of Roux's method.

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“…Conversion of a Polya gastrectomy to a Billroth I reconstruction often results in relief of symptoms of this sort (Tanner, 1966), and would be expected to restore the relationship between the two smooth muscle organs. SUMMARY Earlier work has indicated a relationship between the tone of the sphincter of Oddi and gastric peristalsis, especially if food is in the stomach.…”

Section: Discussionmentioning

confidence: 99%

Effect of gastrectomy on biliary dynamics.

Wyatt¹

1969

Gut

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A recent study of the physiology of flow through the sphincter of Oddi (Wyatt, 1967) indicated that amongst other factors gastric peristalsis was related to changes of resistance at the sphincter. This was especially notable when food was present in the stomach. Electrical stimuli leading to contraction of the gastric antrum often resulted in relaxation of the sphincter with increased flow through it. This relationship did not depend on extrinsic nervous connexions and was therefore supposed to depend on the continuity of smooth muscle of the stomach, duodenum, and sphincter of Oddi, or on the intrinsic nerve plexus of the bowel in this region. This raises the question as to what effect, if any, there is on bile flow when the stomach is disconnected from the duodenum as in a Polya type of gastrectomy. Further experiments are now reported which show that there are changes in biliary flow and pressure patterns after this type of operation.EXPERIMENT 1

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Disabilities Which May Follow the Peptic Ulcer Operation

Cited by 17 publications

References 2 publications

Gallstones and gastric cancer: A matched case‐control study

Gallstones and gastric cancer: A matched case‐control study

Roux‐en‐Y

Effect of gastrectomy on biliary dynamics.

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