Abstract

IN A FOLLOW-UP study of 699 patients who had undergone gastrectomy Rauch reported1that slightly over 80% lost weight after surgery (an average weight loss of 13.8 lb., or 6.3 kg., in a patient with peptic ulceration). Others2have reported a somewhat lower incidence. While many such patients undoubtedly had minimal weight losses and others may have been on voluntary reduction diets, the frequency and magnitude of this complication led us to investigate further the possible causes. Faulty digestion and absorption of foodstuffs has been suggested3as a cause for the failure of postgastrectomy patients to gain weight. It has been intimated4that the degree of interference with the digestion of oral nutrients might be dependent on the type of anastomosis performed. In general, there are three types of anastomoses employed to reestablish the continuity of the gastrointestinal tract after a subtotal gastric resection: the gastroduodenostomy,

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