FEW OPERATIONS give the patient more gratifying results with less risk than does a well-executed subtotal gastrectomy for treating a peptic ulcer which has failed to respond to medical treatment. The operative mortality and postoperative morbidity following subtotal gastric resection have been decreased to a comforting degree because of the improved preoperative preparation of patients, refinements in anesthesia, improved understanding of fluid and electrolyte balance, and early ambulation.* Nevertheless, postoperative stomal complications occur often enough to warrant some discussion of their management. These complications are (1) the "dumping syndrome," (2) obstruction of the stoma between the stomach and jejunum, and (3) bleeding from the stoma. This paper will outline techniques and, by case reports, illustrate methods for correcting these conditions.
The dumping syndrome produces probably the most annoying and one of the least understood series of complaints following subtotal gastric resection. Dumping syndromes usually subside with time and conservative measures,