Emptying of the gastric substitute after total gastrectomy: Jejunal interposition versus Roux-y esophagojejunostomy
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Contributors
Abstract
Emptying of the gastric substitute and small bowel transit time of a 99(m)Tc-labeled solid test meal were measured in 20 tumor-free patients 13 to 63 (median, 35) months after total gastrectomy with Roux-y (n = 11) and jejunal interposition (n = 9) reconstruction. The emptying half-times ranged from 2 minutes to >20 minutes. Rapid emptying was associated with dumping symptoms (p < 0.03) and shorter orocoecal transit-time (p < 0.05). Serum glucose concentrations rose more quickly in jejunal interposition, but the areas under the curve were identical in both groups. The median insulin-to-glucose ratio (areas under the curve) during the 20 minutes after the meal was 11.4 in jejunal interposition and 7.1 in Roux-y esophagojejunostomy (NS). Interposition cases had regained a significantly higher percentage (89%) of their premorbid weight than patients with Roux-y (78%; p < 0.05). The weight/height2 ratio was above the 50th centile in 45% of interpositions, but below the 50th centile in all patients after the Roux-y mode of reconstruction (p < 0.05). It is concluded that the emptying velocity of the gastic substitute has no impact on postoperative weight gain. The authors contend that the concept of a gastric substitute pouch is not supported by the findings of this study.
Details
Original language | English |
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Pages (from-to) | 165-172 |
Number of pages | 8 |
Journal | Annals of surgery |
Volume | 210 |
Issue number | 2 |
Publication status | Published - 1989 |
Peer-reviewed | Yes |
Externally published | Yes |
External IDs
PubMed | 2667472 |
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