[4] Post-operatively, up to 70% of patients undergoing total gastrectomy develop complications such as dumping syndrome and reflux esophagitis.

[5] A meta-analysis of 25 studies found that construction of a "pouch", which serves as a "stomach substitute", reduced the incidence of dumping syndrome and reflux esophagitis by 73% and 63% respectively, and led to improvements in quality-of-life, nutritional outcomes, and body mass index.

[5] After Bilroth II surgery, a small amount of residual gastric tissue may remain in the duodenum.

[7] These are now usually treated with antibiotics, as it was recognized that they are usually due to Helicobacter pylori infection or chemical imbalances in the gastric juices.

In the past a gastrectomy for peptic ulcer disease was often accompanied by a vagotomy, to reduce acid production.