Quality of Life and Nutritional Outcomes of Billroth I and Billroth II Reconstruction

2002 ◽  
Vol 2 (2) ◽  
pp. 91 ◽  
Author(s):  
Wansik Yu ◽  
Ho Young Chung
2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 140-140
Author(s):  
Maithao N. Le ◽  
Jacob Ellenhorn ◽  
Joseph Kim ◽  
Vijay Trisal ◽  
Joshua D. I. Ellenhorn

140 Background: Laparoscopic gastrectomy has been proposed as a procedure to reduce the morbidity of gastric cancer surgery. Modified Billroth II (BII) reconstruction with a side to side loop gastrojejunostomy is technically straightforward to accomplish laparoscopically. To determine the long term morbidity of this reconstruction technique, we performed a quality of life (QOL) analysis of patients undergoing laparoscopic distal gastrectomy with modified BII reconstruction. Methods: Between June 2005 and May 2011, 64 patients underwent laparoscopic distal gastrectomy with modified BII reconstruction at City of Hope Medical Center (COH). Patients alive with no evidence of disease were recruited to participate in the QOL study. The study was approved by the Institutional Research Board of COH. Research subjects completed the EORTC QOL-STO22 instrument which queried patients for post gastrectomy symptoms. Comparison between groups was done using the Student-t test. Results: 33 of 64 patients met the criteria for participation in our QOL study. Of these, 23 patients consented to participate and completed the EORTC QOL-STO22 instrument. Overall, 81% categorized symptoms as occurring “not-at-all” or “a-little” while 19% reported symptoms occurring “quite-a-bit” or “very-much”. Since symptoms could be worse in patients with small gastric pouches, we divided our cohort into two groups, one having at least 70% of the stomach resected (12 patients) and the other having less than 70% of the stomach resected (11 patients). The two groups were compared with respect to symptoms. There was no difference between the groups with respect to dysphasia (p=0.80), pain (p=0.98), reflux (p=0.93), and eating restriction (p=0.33). Overall 78% of patients with a small gastric pouch and 83% of patients with a larger gastric pouch reported these symptoms as occurring “not-at-all” or “a-little”. Conclusions: Laparoscopic distal gastrectomy with modified BII reconstruction resulted in an acceptable morbidity rate with few patients experiencing severe symptoms. Gastric pouch size did not predict symptoms and most patients with a small gastric pouch report excellent QOL.


Author(s):  
Marc A. Barandun ◽  
Ronan A. Mullins ◽  
Ulrich Rytz

Abstract CASE DESCRIPTION A 9-year-old castrated male domestic shorthair cat (cat 1) and a 10-year-old castrated male Maine Coon cat (cat 2) were presented for recurrent feline lower urinary tract disease after receiving outpatient care from their primary veterinarians. CLINICAL FINDINGS Physical examination findings for both cats were initially within reference limits. After a short period of hospitalization, both cats developed peritoneal effusion; results of cytologic analysis of a sample of the fluid were consistent with septic peritonitis. During exploratory laparotomy, perforation of the pylorus or proximal portion of the duodenum secondary to ulceration was identified. TREATMENT AND OUTCOME Both cats underwent partial duodenectomy, partial gastrectomy (pylorectomy), and gastrojejunostomy (Billroth II procedure). The cats recovered from surgery and returned to a normal quality of life; however, each had mild episodes of anorexia but maintained a stable body weight. Cat 2 required additional surgery for trichobezoar removal 7 weeks later but recovered quickly. At 7 months after trichobezoar removal, cat 2 developed intermittent vomiting, but clinicopathologic, abdominal ultrasonographic, and upper gastrointestinal tract endoscopic findings were within reference limits. At 9 (cat 2) and 13 (cat 1) months after the Billroth II procedure, both cats were reported to be in good general health and without gastrointestinal signs. CLINICAL RELEVANCE In both cats, the Billroth II procedure was technically straightforward and associated with a full recovery and good medium- to long-term quality of life. A Billroth II procedure could be considered for treatment of cats with large mural lesions in the pyloroduodenal region.


2020 ◽  
Vol 64 (1) ◽  
pp. 28-33
Author(s):  
T. Morgoshiya

When comparing the results of surgical interventions in the modifications of Billroth-I and Billroth-II concerning carcinoma there are no significant differences both in immediate and in long-term results of treatment. At the same time the functional results of interventions and quality of life of patients are better after reconstruction of the digestive tract with the help of gastroduodenal anastomosis. Gastric stump cancer is more often occur after Billroth-II surgery. The main cause of the development of carcinoma in this case is the appearance of atrophic gastritis as a result of denervation of the organ and the transfer of bile to the operated stomach.


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