Mucosal changes of the Billroth II resected stomach. A follow-up study of patients resected for duodenal ulcer,with special reference to gastritis, atypia and cancer.
In a follow-up study of a consecutive series of 1000 patients, who underwent Billroth II resection for duodenal ulcer 22-30 years earlier, the mucosal changes of the gastric stump could be studied by endoscopy and biopsy in 196 cases. At the histological examination only 7.1% of the patients had a normal gastric mucosa: the remaining 92.9% had chronic atrophic gastritis., which was diffuse and most marked at the gastro-jejunostomy. In 7.1% of the cases the inflammation was accompanied by focal accumulation of lipophages. 12.2% had non-neoplastic polyp formation caused either by cystic glandular dilatation of the mucosa at the gastro-jejunostomy, eosinophilic granulomatous polyps or protrusion of the mucosa at the lesser curvature caused by invagination at the resection. 14.8% of the patients had epithelial atypia close to the anastomosis, but no cancers were found, and it is concluded that the presented results do not indicate a cancer prophylactic endoscopic screening of patients treated with Billroth II resection for duodenal ulcer.