[Causes of dehiscence in the anastomosis between the stomach and small intestine in our clinical data 1970-1990].
Gastrojejunal anastomotic leakage occurred in our clinical material of 4284 gastric resections Billroth II type with an incidence of 0.93 percent. 62 cases with anastomotic dehiscence were analyzed, with 22 from other clinics. The most critical part of the anastomosis was the upper angle of Billroth II Hoffmeister Finsterer anastomosis. The causes were mostly local; reoperations and resuture with necrotic and devitalized tissue, impaired vascularization of the stomach and small intestine due to rough manipulation, too narrow anastomosis and too tight securing of ligatures, as well as too massive tissue aglomeration in more layers. Stomach obstruction is a significant cause, as it is dista obstruction to anastomosis, duodenal dehiscence, peritonitis or pancreatitis. Some of the local causes are likely to be solved with using of one layer of resorptive suture material or using of a stapling device. General conditions are also important, but only as factors that stress the local conditions of risk. The mortality rate in this serial is high as 70.9%, in spite of the reoperations and complex conservative treatment.