Unsuccessful experience with closure of Jaboulay gastroduodenostomies in the treatment of post-vagotomy dumping and diarrhea.

Eight patients after vagotomy and Jaboulay gastroduodenostomy had their gastroduodenostomy closed to treat dumping and diarrhea. Eight gastroduodenostomies were closed once and four were closed twice, a total of 12 procedures. Of these, ten were "simple" closures (direct suture of the opening into the duodenum via a gastrotomy) and two were "formal" (gastroduodenostomy formally dismantled). Among those gastroduodenostomies closed "simply," the closure remained intact for 2 to 9 months, relieving the patients' symptoms. Thereafter, the suture line broke down, leaving the patient with a patent gastroduodenostomy and recurrent symptoms. The two patients closed "formally" developed severe complications: one patient's stomach failed to empty permanently after the procedure and the second developed a duodenal leak. In addition to these major complications, another four of the 12 procedures were followed by transient gastric retention, and five of the 12 procedures were accompanied by minor pulmonary and wound complications. A satisfactory result was not achieved in any patient.