Pyloroplasty versus gastrojejunostomy: Results of a double-blind, randomized, controlled trial

Abstract

Abstract A double-blind, randomized, controlled trial of Finney pyloroplasty and gastrojejunostomy, each with selective vagotomy, is reported. There were no operative deaths but 5 patients have subsequently died or have been lost to follow-up, leaving 94 patients, with a mean follow-up time of 3 1/2 years. There has been 1 proven recurrence after gastrojejunostomy and 2 after pyloroplasty, with 1 further suspected recurrence in each group. The clinical grading marginally favoured gastrojejunostomy. There was no significant difference in the incidence of bilious vomiting, dumping, diarrhoea, or other disturbances, but there was a significantly greater increase in bowel frequency after pyloroplasty. Weight changes were similar, and there was no gross anaemia or calcium deficiency in either group. Gastrojejunostomy is reversible and pyloroplasty is not, and therefore we recommend gastrojejunostomy as the drainage procedure of choice when drainage is necessary after vagotomy.