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Favorable Postgastrectomy Results in Billroth II Patients with a Small Stoma

J. J. McCAUGHAN Jr., M.D.; RALPH F. BOWERS, M.D.
AMA Arch Surg. 1958;77(6):837-842. doi:10.1001/archsurg.1958.01290050007002.
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The authors report a clinical experiment conducted over a course of six years presenting evidence that favors the small, but not too small, stoma, and shows that better results are thereby accomplished. We therefore do not need to use the Billroth I operation.

The Billroth II type of gastric resection has been largely accepted by surgeons for its ability to prevent peptic ulcer recurrence if definitive operation is required. The recurrence rate is the lowest for all procedures, and the mortality and immediate morbidity rates are comparable. However, the late postgastrectomy findings of weight loss, diarrhea, and the dumping syndrome with accompanying weakness are believed to be more numerous than those with other procedures, notably gastroenterostomy and the Billroth I procedure. These disagreeable sequelae have urged surgeons to find a better operative procedure.1-12 It is apparent that if the postgastrectomy symptoms could be prevented or materially lessened, then the

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