Endoscopic and morphological features of gastroenteroanastomosis in patients with complications after gastrectomy

Abstract

Aim. 314 ulcer disease patients with pathology of gastro-enteric anastomosis (GEA) have been examined after intestinal and duodenal resection.Methods and results. Early post gastro resection complications (51 patients): I group – evacuation disorders (anastomositis – 35%; infiltration in the area of anastomosis – 10%); II group – bleeding (acute erosive and ulcerative lesions – 17%). Features of early anastomositis (perioperative and deferred) are the following – more lesions of gastric anastomosis, focal ischemia and micro-necrosis, acute inflammation, marked angiomatosis forming sinusoids as a possible source of bleeding. Late post gastro resection pathology of anastomosis (263 patients): I group – evacuation disorders (anastomositis – 14.1%, stenosis of GEA – 5.3%); II group – pain syndrome (peptic ulcer of GEA – 8.4%, HP-associated atrophic gastritis – 31.2%); III group – bleeding (peptic ulcer of GEA – 4.1%).Conclusion. Features of the late post gastro resection pathology of anastomosis are the following – disorder of mucosa architectonics (polymorphism of glands, joint of atrophic, hyperplastic and cystic changes); joint of dysplastic changes with the loss of basement membrane, fibrous deformation of mucosa, increase of the total volume of the lamina propria of mucosa; formation of erosions.