| [ Summary ] |
Fourteen patients with a carcinoma of the remnant stomach who had undergone distal gastrectomy and Billroth I anastomosis (B-I) were compared with 17 patients with Billroth II anastomosis (B-II). Patients with B-II anastomosis had a lower average age at the first operation, a longer interval between the first and second operation, and tumors closer to the anastomotic line as compared to those with B-I anastomosis. Most tumors within 2cm of the anastomotic line were found in patients with B-II anastomosis and with an interval of 30 to 40 years between the first and second operations. These results suggest that duodenal reflux can be a carcinogenic factor in the remnant stomach. On the other hand, in patients with an interval of 20 years or less between the first and second operations, B-I anastomosis was performed in 85%, and tumors were located distant from the anastomotic line. These observations suggest that reconstruction procedures or duodenal reflux may not be related to carcinogenesis in the remnant stomach in these patients. |