THE POSTGASTRECTOMY SYNDROMES

Abstract
About 85% of patients treated for the complications of duodenal ulcer by subtotal gastrectomy may be classified as having good or excellent results, but the remaining 15% fail to improve significantly. Most of the poor results following this operation are not due to recurrence of ulcer disease but are due to the altered anatomy and physiology produced by the operative procedure. "Dumping syndrome" has often been used as an inclusive term to refer to all types of symptoms that may occur after gastrectomy. At the present time, however, it is possible to differentiate several postgastrectomy syndromes so that a careful evaluation of the patient with symptoms will lead to a more specific diagnosis that will allow a rational approach to therapy. The most common syndrome, which occurs in 15 to 40% of all patients treated, is characterized by postprandial weakness, sweating, pallor, increased pulse rate, nausea, vomiting, and diarrhea. Symptoms