Refluxgrößen des operierten Magens

Postoperative duodenal or jejunogastric reflux of bile acids and lysolecithin was measured in 189 patients with different types of operation for ulcer and in 35 control subjects. After selective proximal vagotomy without pyloroplasty there was a normal reflux, but after additional pyloroplasty (after Heineke-Mikulicz or Jaboulay) there was a slightly increased concentration of bile acids and lysolecithin. After gastric resection (Billroth I) values were four to eight times those after vagotomy with pyloroplasty or nine to sixteen-fold the normal amount. Reflux values twice as high as after Billroth I were found in patients after Billroth II resection without Braun's enteroanastomosis. Additional Braun's enteroanastomosis reduced the lysolecithin and bile acid concentration after Billroth II to levels after Billroth I. Normal reflux values after gastric resection were achieved by a Roux-Y gastroenterostomy and 25-cm long isoperistaltic jejunal interposition as an anastomosis variant.