Early dumping reaction after partial gastrectomy and its relation to preoperative apomorphine testing.

Risk factors for postoperative early dumping symptoms were studied prospectively in 289 consecutive peptic ulcer patients followed up for 5 years after antrectomy and gastroduodenostomy with or without vagotomy. Grade 2 or 3 dumping was present in 14% of the patients and was about four times as frequent in women as in men after antrectomy alone. The incidence of such dumping grades was twice as high after combined antrectomy and vagotomy as after antrectomy alone. Both differences were statistically significant. Milk intolerance, which often appeared as a symptom of dumping, was more common after combined antrectomy and vagotomy. Dumping seemed primarily to be related to the sex of the patient or to milk intolerance, whereas vagotomy additional to antrectomy seemed to enhance the risk of incurring dumping by causing milk intolerance. Grade 2 or 3 dumping was statistically associated with postoperative loss of weight. Pre operative apomorphine test was performed with the aim of detecting predisposition to postoperative dumping reaction. The authors conclude that apomorphine test preoperatively cannot predict postoperative dumping.