Physiological and clinical study of patients after subtotal gastrectomy

The Late Effects of Total and Subtotal Gastrectomy

“…This figure is more in line with the results reported in earlier series. [13][14][15] The value of statistical analysis is exemplified by a paper by Santy and Mallet-Guy.16 These authors divided their material according to the length of the postoperative period and showed that whereas SO per cent of the patients followed for one to three years failed to regain their normal weight, only a few of the patients observed over longer intervals experienced difficulty in putting on weight. Furthermore, of the 50 per cent who failed to regain their normal weight, only one third that is, 17 per cent of the whole group failed to maintain their preoperative weight.…”

“…The partially resected stomach sometimes exhibits peristaltic waves,27,31 but in other cases peristalsis is not seen,32 and the general motility pattern tends to be abnormal. 15 Eventually, gastric emptying may occur intermittently and rhythmically, a phenomenon that has suggested to some that a new sphincter is formed by the gastric muscle that adjoins the stoma.14'30 Schindler33 states that the stoma, as seen through the gastroscope, usually appears patent and rigid, but that in 4 out of 41 patients who had undergone resection for ulcer a rhythmic, pyloruslike activity of the sphincter was seen. Most observers do not believe that a new sphincter forms at the site of the stoma, Vitkin27 maintaining that the stomal aperture is opened and closed by the efferent jejunal loop.…”