1986 Volume 28 Issue 6 Pages 1237-1245
Endoscopic findings of the stoma in 193 cases following Billroth-I and -II gastroctomy were investigated. Stomal ulcers were confirmed in 34 cases endoscopically, 17 of 128 cases following Billroth-I, and 17 of 65 cases following Billroth-II, respectively. The incidence of stomal ulcer after Billroth-II (26.2%) was higher than that of Billroth-I (13.3%). In cases of Billroth-I gastrectomy, 15 ulcers were found on the suture line, and 6 of them (40%) were associated with non-absorbable suture material. On the other hand, in Billroth-II 13 ulcers were found on jejunum, however, any ulcer associated with non-absorbable suture material was not found. Therefore Stomal ulcer associated with non-absorbable suture material have a tendency to occur after Billroth I gastrectomy. In the 6 cases of stomal ulcer associated with non-absorbable suture material mentioned above, the ulcer healed within a month in 3 cases in which the suture material was removed by endoscopy. But in the other 3 cases, in which the suture material was not removed, the ulcer continued to be present. On diagnosis of stomal ulcer, it is important to ascentain the presence of suture material. If suture material is present, endoscopic removal of the suture material is an effective treatment.
