[A removable mold--unimportant?].
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Biomedical subjects
Publications and source records attributed to A Garbrecht.
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Intragastric concentrations of bile acids, lysolecithin, 14C-bile acids, pH-value, bacterial growth and gastric mucosa histology were analysed in 47 patients following selective proximal vagotomy with and without pyloroplasty. Without pyloroplasty there were normal amounts of lysolecithin, bile acids and 14C-marked bile acids. Following pyloroplasty (Heineke-Mikulicz and Jabouly) the reflux values were 2 to 4 times higher. This increase of reflux after pyloroplasty was only one fifth of that following gastric resection. Only 20% of the vagotomized stomachs showed a bacterial contamination, an atrophic gastritis could be observed in 20% of the pyloroplasty-patients. The results demonstrate, that in selective proximal vagotomy there is no, in combination with pyloroplasty only a slight reflux gastritis.
1. After gastrectomy or vogotomy with pyloroplasty the reflux of bile acids and lysolecithin increased. 2. The highest values of reflux were observed in the retrocolic (short loop) B-II anastomosis. The different types of B-I antrectomy and the antecolic B-II with Braun's enterostomy have each the same reflux, which is significantly lower than the retrocolic B-II. Even these types of gastrectomy have 6 - 10-fold elevated reflux values compared to the controls. After vagotomy with pyloroplasty the reflux was reduced to two or three times normal. After selective proximal vagotomy without pyloroplasty no reflux was observed. 3. After an isoperistaltic jejunal transportation, the reflux was reduced, the reduction depending on the length of the transposed segment. The same result was obtained with a ROUX-en-Y-gastro-enterostomy. 4. After hemigastrectomy and isoperistaltic transposition of 25 cm of jejunum, more reflux could be observed under experimental and clinical conditions.