Billroth II Gastrojejunostomy in Dogs Stapling Technique and Postoperative Complications |
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| Authors: | FAISAL AHMADU-SUKA dvm ms PhD STEPHEN J WITHROW dvm Diplomateacvs A WENDELL NELSON dvm PhD Diplomateacvs PAUL W HUSTED dvm ms EDWARD L GILLETTE dvm PhD Diplomateacvr C E WHITEMAN dvm PhD Diplomateacvp |
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| Institution: | Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado;Department of Radiology and Radiation Biology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado;Department of Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado |
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| Abstract: | Billroth II gastrojejunostomy was performed with surgical staplers in 6 dogs that were not irradiated and in 11 dogs that subsequently received radiation to the pancreas and proximal part of the duodenum. The dogs were monitored clinically for 135 days and then euthanatized and necropsied. Each gastrojejunostomy site was preserved in formalin and the stomal diameter was measured. No mechanical complications were encountered with the use of surgical staplers and no leakage was observed at the staple closure sites before abdominal closure. All dogs vomited approximately 100 ml of coagulated blood 4 to 8 hours after surgery, and 300 to 400 ml of brown fluid after approximately 24 hours. Vomiting was the most common clinical finding after the first 24 hours. Vomiting was subjectively graded from 1 to 3 with grade 1 representing the least severe problem and grade 3 the most severe. Grade 1 vomiting occurred in 12 of 16 dogs that survived 135 days; in the other four dogs, vomiting was classified as grade 2 or 3. All dogs with grade 1 vomiting had stomal diameters of 1.7 to 2.9 cm (mean, 2.2 ± 0.4 cm standard deviation). Dogs with grade 2 or 3 vomiting had stomal diameters of 2.2 to 4.0 cm (mean, 3.2 ± 0.8 cm standard deviation). The difference was statistically significant (p < 0.005). The percentage of weight gained or lost was recorded for each dog. Two nonirradiated dogs gained body weight, whereas the other nonirradiated dogs and all irradiated dogs lost body weight. The overall mean loss of body weight of dogs with grade 1 vomiting was 16.7 ± 12.0% (± standard deviation), compared with 35.5 ± 6.6% (± standard deviation) for dogs with grade 2 or 3 vomiting; the difference was significant (p < 0.01). Routinely scheduled clinical laboratory test results were within normal limits in nonirradiated dogs. Clinical problems other than vomiting and weight loss were anorexia, gastric dilatation, and diarrhea. One nonirradiated dog died on day 56 after rupture at the gastric stump staple line. |
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