Analysis Of The Long Term Complications Of Patients Suffered From Subtotal Gastrectomy Due To Benign Gastroduodenal Diseases

Objective To analysis the long term complications and life qualities of patients suffered from subtotal gastrectomy due to benign gastroduodenal diseases, especially the relationship between the complications and the different operative way of reconstruction.Methods 116 patients after subtotal gastrectomy more than 10 years due to benign gastroduodenal diseases were selected as study group, while 80 cases for healthy examination as matched control group. Life qualities were investigated by GIQLI (gastro-intestinal quality of life index) in both study and control group. Gastroscope and nutrition status investigation were made in the study group.Results GIQLI investigation indicates that the life qualities of the study group were significantly decreased compared to those of the control group (102.5±10.2 vs 118.3±8.1,P<0.05); at the same time, the levels of serum folic acid, vitamin B12, ferritin and albumin were significantly lower than those in the control (P<0.05). Anemia and osteoporosis were significantly higher than those in the control (P<0.05). 116 patients suffered from stump gastritis in varying degrees, including 49 cases of bile reflux gastritis (42.2%), 20 cases of ulcer disease (17.2%),43 cases of Helicobacter pylori infection (37.1%), 5 cases of gastric stump carcinoma (4.3%);21 cases of anemia (18.1%),29 cases of osteoporosis (25.0%).Concered the ulcer disease , there were significant differences between the Billroth II to BillrothⅠ(12.8% vs 23.9%, P<0.05); While to the bile reflux gastritis ,the result was on the contrary(48.6% vs 23.6%, P<0.05 );No statistical difference was found in other points(P>0.05).Conclusions Patients after subtotal gastrectomy more than 10 years due to benign gastroduodenal diseases have suffered from bile reflux gastritis, relapse of the ulcer, gastric stump caicinoma, malnutrition and so on. The life qualities of the study group were significantly lower than those in the control group, but no difference was fond between BillrothⅠand Billroth II. The ulcer disease was mainly seen in the BillrothⅠwhile the bile reflux gastritis was mainly seen in the BillrothⅡ, there is no difference in the H. pylori infection ratio between the two operative way. Bile reflux after gastrectomy may play an important role in the carcinogenesis of the stump gastric.