[The effectiveness of Braun's anastomosis in Billroth II surgery. The role of hepatobiliary sequence scintigraphy (HBSS) in the diagnosis of bile flow following stomach resection]. / Zur Effektivität der Braunschen Fusspunktanastomose bei der Operation nach Billroth II. Stellenwert der hepatobiliären Sequenzszintigraphie (HBSS) bei der Diagnostik des Galleflusses nach Magenresektion.

ABSTRACT

After resection of the stomach the alkaline reflux of the duodenal contents into the residual stomach is a major factor to be taken into consideration when assessing the causes leading to irregularities of the mucosal barrier. Illnesses that may arise subsequent to gastric surgery are gastritis of the resected stomach, inflammation of the anastomosis, anastomotic ulcers and--with reservations--anastomotic carcinoma. In view of these clinical pictures, a protective function for the biliary system is ascribed to Braun's entero-anastomosis. With the aid of hepatobiliary sequence scintigraphy (HBSS) a functional analysis was obtained from 30 patients, subsequent to gastric surgery--after Billroth II with entero-anastomosis--which showed a surprisingly high rate of reflux into the residual stomach, in 16 out of these 30 patients. The high-grade HBSS data with regard to the biliary reflux proportions after gastric surgery and the low-grade effectiveness of Braun's entero-anastomosis are clearly evidenced.