285 times gastrocamera examinations have been experienced in 180 cases after gastrectomy. This lime, on the basis of their datum, the problems about the remained stomachs after gastrectomy and gastritis were clinically observed. As the result, in almost all the cases, various kinds of gastritis were found on the gastrocamera images of the remained stomach after gastrectomy. But the relation between the images of gastric mucous membrane and the subjective symptoms ofter operation, was positively identified. And among the cases after gastrectomy, there was a smallest number of complaints on the case that preoperative original disease wag gastric cancer. As this time, whether patients have symptome or not, the gastrocamera images mostly showed atrophic gastritis and superficial atrophic gastritis, while in the cases that preoperative was benign gastric disease, (ulcer, gastritis etc.), most patients have complaints after operation. Especially, the tendency is identified that patients of chronic gastritis make a complaint for a long time and the gastrocamera images show superficial a atrophic gastritis. Accordingly, we, surgeon, should be deliberate in judging adaptability when we operate upon patients of chronic gastritis. As for the factors of revelation of subjective symptoms after gastrectomy, students have taken stress on gastritis of the remained stomach, but, this time, my study suggests that we had better continue studying with the considertion of some factors or other. And the outline of the method for gastrocamera photographing of remained stomach after gastrectomy was shown and the results of photographing were unexpectedly good.

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A study was conducted on the mucosal changes in the postoperative stomachs by means of gastrocamera and suction biopsy. The gastrocamera is an excellent diagnostic tool, but the diagnostic criteria in the gastric remnants had to be reevaluated. The subject consisted of 116 cases who had undergone surgery I week to 20 years prior to our study. Because of the anatomical reasons of the gastric remnants, it is difficult to maintain sufficient distance between the camera and the mucosa. Furthermore, the camera tends to face the mucosa in the right angle. Reflexion of light, therefore, may become excessive, giving a false impression of edema. Reproduction of the details of the mucosal surface is difficult for the same reason. Unequal distensibility of the gastric wall between the parastomal areas and the other portions of the stomach also gives an additional difficulty to a detailed obseration of the mucosa. As expected from these facts, a minor degree of apparent edema and mucus exsudation is not always diagnostic of superficial gastritis and such diagnostic criteria in gastrocamera, therefore, should be modified in the study of postoperative stomachs. It was noted that the verrucous apperance of the mucosa can alter considerably in the postoperative stomachs depending upon the condition at the time of examination. For this reason the diagnosis of the so-called hypertrophic gastritis should be made with a great care. The diagnosis by camera of atrophic gastritis is fairly reliable. It should be remembered, however, that atrophy is occasionally covered and concealed by superficial edema which is not uncommon in the gastric remnants. Atrophic gastritis was most common in the postoperative cases, and in 84 of 116 cases (72%) there occured this type of gastritis. The next common finding was sugerf icial gastritit affecting 16 cases (14%). A comparative stude wasmade between the histological examination of the proximal ends of teh resected stomachs and corresponding biopsy tissues taken from the viscinify of the stomas, in an attempt to compare pre-and post-operative gastritis. Regardless of the period after surgery, similar type of gastritis that seen in the preoperative stomachs was observed postoperatively in 71% of the cases. Superficial gastritis progressed to atrophic gastritis after surgery in 17% of the cases. Thus a continuation or aggravation of preoperative gastritis was noted in the gastric remnants of most patients.

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