Previous Partial Gastrectomy Research Articles

Gastroscopy with Directed Biopsy and Routine X-ray Examination in the Diagnosis of Malignancies of the Stomach. A Retrospective Study

The examinations were performed in 418 patients with malignancy or an ulcer of the stomach. In all cases the Cancer Registry of Norway was asked for the final diagnosis and date of death. The diagnosis of malignancy was based on histology on operated or autopsy specimens, and the surviving cases were re-examined by answering a questionnaire. At the time of the primary examination a total of 103 cases of malignancies were found, of whom 41 were women. 84 patients had not been operated on previously. Among these 7 cases of early carcinoma were found. In 19 patients a partial gastrectomy had been performed. A false diagnosis of benign lesion was given on biopsy in 2 per cent, by gastroscopy in 8, and by X-ray examination in 31 per cent. A definite diagnosis of malignancy was made correctly by the same procedures in 95, 53 and 16 per cent, respectively. After 30 months of observation 16 cases of malignant lesions were reported among the patients (315) who had an ulcer of the stomach with benign histology on directed biopsy at the primary examination. A false benign diagnosis had been made in 33 per cent of 119 with malignancy by X-ray examination, in 10 per cent by gastroscopy, and in 15 per cent by histology on biopsy. The corresponding percentages in the total material of cases with benign and malignant lesions were 10.2, 2.9, and 4.3, respectively. In cases with previous partial gastrectomy, and in those with early cancers much higher rates of false negative diagnosis of malignancy has so far been suggested in 12 per cent of cases with benign ulcers, a gastroscopical diagnosis has been suggested in 22 per cent, and a bioptical in none. A combination of diagnostic procedures provided a correct diagnosis of malignancy in 118 out of 119 patients.

Long term results of gastrectomy with respect to blood lipids, blood pressure, weight and living habits.

A sample of ambulant Japanese-American men (ages 45-69 years), was divided into those having a previous partial gastrectomy and a control non-gastrectomy population. Three-hundred-and-forty-seven men with a history of partial gastrectomy weighed less and had lower values for serum cholesterol, triglyceride, and blood pressure than did the control population of 7,598 men. The depressed lipid and blood pressure values could not be entirely explained by the reduced weight. Likewise, none of these differences appeared related to diet or living habits. Those operated on for gastric ulcer had, on the average, lower systolic pressures than duodenal ulcer patients and those with gastrojejunal anastamoses had lower cholesterol levels than patients with a gastroduodenostomy.

Retroperitoneal rupture of duodenum with complicating gas gangrene.

Two patients suffered duodenal rupture as a result of blunt trauma and developed gas gangrene of the peritoneal and retroperitoneal areas. Diagnosis of the rupture was delayed, as is often true in such cases. Both patients died despite antitoxin, large doses of antibiotics, and as much debridement as could be done within limits compatible with life. Both patients had undergone previous partial gastrectomy and vagotomy for duodenal ulcer. We suggest that the alterations in bacterial flora in the upper gastrointestinal tract attendant on gastrectomy and vagotomy may place patients with duodenal rupture at greater risk from gas gangrene than those with normal gastroduodenal segments.