Pylorus and antroseromuscular flap-preserving gastrectomy--a new type of reconstruction after subtotal gastrectomy for treatment of gastroduodenal ulcer: clinical and experimental study.

To avoid motility disturbances after Billroth gastrectomy, the authors designed pylorus and antroseromuscular flap-preserving subtotal gastrectomy (PAFPG). Results showed that gastric motility and emptying time of dogs after PAFPG were close to normal. PAFPG was applied to 125 consecutive patients with gastroduodenal ulcers (gastric ulcer, 15 patients; duodenal ulcer, 94 patients; and combined ulcers, 16 patients) confirmed by barium examination and fibro-gastroendoscopy. All patients recovered smoothly, none of them had postoperative complication. Gastric acid output reduction rates were as follows: basal acid output, 85.05% +/- 8.13%; maximal acid output, 81.76% +/- 10.85%; peak acid output, 81.42% +/- 10.15%. The incidence of postoperative enterogastric reflux (endoscopically) and the concentration of cholic acids in gastric juice were significantly lower in patients after PAFPG than after Billroth I or II gastrectomy. Results suggest that PAFPG reduced gastric acid outputs definitely and overcame adverse motility consequences after Billroth I or II gastrectomy desirably.