A review of symptoms, haematology and clinical chemistry following a partial gastrectomy.

Abstract

Abstract A review of patients following a partial gastrectomy for benign peptic ulceration reveals very satisfactory symptomatic results. Minimal haematological and biochemical disturbances have been produced and all the patients with gastric ulcers were cured. The gastric resection has been limited to two-thirds in all the cases. One hundred and ninety patients were included in the review, and of these, 99 underwent detailed haematological and biochemical investigation. Ninety per cent of the patients were graded as Visick I or II. There was a low incidence of severe vomiting (1.5 per cent), diarrhoea (1.5 per cent) and dumping (1.9 per cent) Anaemia was manifest only in males (18 per cent). Iron deficiency was present in both sexes and increased in severity with time. The deficiency has been readily corrected with oral iron. There was no macrocytic anaemia, 10 per cent of patients having subnormal serum vitamin B12 levels. There was no folate deficiency. No biochemical abnormality was noted. Eight patients treated for duodenal ulcers developed recurrent ulcers but 6 of these followed Billroth I gastrectomy. Recurrence following a Poly a gastrectomy was 2 per cent. No gastric ulcer recurred. These findings justify treatment of both duodenal and gastric ulcers by partial gastrectomy. A modification of the Billroth I operation was used to overcome technical problems. Operation details are given and it is suggested that this operation is ideal for gastric ulcer.