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MECHANISM OF THE EFFERENT STOMA DYSFUNCTION FOLLOWING SUBTOTAL GASTRECTOMY

JOHN VAN PROHASKA, M.D.; MICHAEL C. GOVOSTIS, M.D.; ANDREW KIRSTEINS, M.D.
AMA Arch Surg. 1954;68(4):491-499. doi:10.1001/archsurg.1954.01260050493012.
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THE VARIOUS methods used to reestablish gastroenteric continuity after subtotal gastrectomy still do not totally obviate unpleasant complications and sequelae. Complications such as obstruction or dysfunction of the efferent jejunal loop, dumping syndrome, and to some extent, nutritional deficiencies appear to be inherent in the surgical rearrangement of the gastroenteric continuity. It is a natural desire to eradicate and correct these disorders even though they occur in only a small percentage of patients after subtotal gastrectomy. This desire is evident in the introduction of the segmental resection of the stomach by Wangensteen1 and the reemphasis of the Billroth-I procedure by Harkins.2 The object of this clinical and anatomical study is to point out a specific mechanism of stomal dysfunction in the early postgastrectomy period.

No doubt there are many causes of malfunction of the efferent jejunal segment. An obstruction may occur after any operative procedure devised for the

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