Billroth I versus Billroth II versus Roux-en-Y after subtotal gastrectomy. Prospective [correction of prespective] randomized study.

Methodology: Forty-five patients were randomized between 1990 and 1995 and stratified in 3 different groups: 15 BI, 15 BII and 15 Roux. They, were investigated by esophagogastroduodenoscopy with multiple biopsies and upper gastrointestinal, scintiscanning, to evaluate gastroesophageal reflux and dynamics of gastric emptying. They also answered a questionnaire: Gastrointestinal Quality of Life Index. Results: A reflux esophagitis was found in 5 BI, in 7 BII and in 2 Roux (p<0,001). No gastric lesions were found in 6 BI, in 5 BII and in 12 Roux, (BI vs. Y, p<0.05; BII vs. Y, p<0.001). Chronic superficial gastritis was present in 9 BI, in 4 BII and in 3 Roux (131 us. Y, p < 0.05). Dynamic scintiscan demonstrated the presence of gastroesophageal reflux in 5 BI and gastric emptying was fast (37'<T1/2<86'), but incomplete (60' residual activity: 49-62%). Gastroesophageal reflux was evident in 7 BII with slow (28'< T1/2 < 143) and incomplete (60' residual activity: 48-72%) gastric emptying. Gastroesophageal reflux was detected in 2 Roux and radioactive bolus progression in the Roux limb was fast (24'<T1/2<53') and complete (60' residual activity: 42-52%) (BI vs. Y; BII vs. Y, p<0,001). There was no statistical significance, between Gastrointestinal Quality of Life Index score in the 3 groups. Conclusions: The Authors affirm that Roux-en-Y is the technique of choice in subtotal gastrectomy, if compared with BI and BII.