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Study of postoperative outcome following Billroth-2 reconstruction after subtotal gastrectomy for carcinoma stomach

Saia Chenkual, Zothansanga Ralte, Venu Gopala Reddy.


Background and Aims: Selection of best available reconstructive surgery after gastrectomy is important because of the post-operative complication related to gastric cancer surgery. Hence this study was undertaken with the aim of studying the postoperative outcomes in Billroth II reconstruction following Subtotal gastrectomy.
Materials & methods: The current cross-sectional study was conducted among 50 patients with carcinoma stomach who underwent Billroth-2 reconstruction after subtotal gastrectomy in the Department of General Surgery, Civil Hospital, Aizawl, Mizoram for over a period of 2 years between May 2015 to May 2017. The data was collected using a pre-tested structured questionnaire. A complete history was taken for all the participants followed by a clinical examination, endoscopic examination and histopathological examination of the biopsy specimen.
Results: The mean age of the study participants was 58± 11.19 years with the majority of the study group within the age group of 50-59 years and 60-69 years (32%) and were males (70%). Epigastric pain was the most common presenting symptom reported by 26% (95% CI 15% to 40.61%) of the patients followed by burning sensation (12% (95% CI 4.9% to 25%)), anorexia (6%(95% CI 1.56 to 17.54%)), nausea and vomiting the least (2%, 95% CI 0.1 to 12.01). 32% (95% CI 19.93-46.83) of the study participants had erythema of gastric mucosa, 16% (95%CI 7.64-29.66) had presence of bile in the stomach. None of the study subjects had any dysplastic changes.
Conclusion: Epigastric pain, burning sensation is the most common clinical symptom following Billroth-II reconstructive surgery. Billroth- II can be considered as a better alternative for most widely used Roux-en-Y gastrojejunostomy owing to its less severe complication.

Key words: Atrophy, Foveolar hyperplasia, Gastric reflux, Gastritis, Reflux esophagitis

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