Reservoir function after subtotal or total gastrectomy with or without gastric substitute.
Volume and pressure characteristics as a measure of reservoir function were studied in three patient groups greater than 1 year after gastrectomy for cancer, one group with straight Roux-en-Y esophagojejunostomy, one with an s-shaped gastric substitute after total gastrectomy, and the third group with subtotal gastrectomy. A large latex balloon was introduced into the proximal jejunum, gastric substitute or gastric remnant and then filled with water at a constant, slow rate. The maximal volume capacity was 400 ml at basal pressure 13.9 cmH2O in the remnant after subtotal gastrectomy and 475 ml at 10.4 cm in the gastric substitute, but only 180 ml at basal pressure 40.4 cmH2O in the proximal Roux limb of the straight esophagojejunostomy. Maximal basal pressure and maximal pressure amplitudes throughout the study period were significantly higher in the patients with straight Roux-en-Y esophagojejunostomy. The results suggest that a gastric substitute constructed as an s-shaped pouch is characterized by pressure and volume typical of a low-pressure reservoir, similar to that achieved by leaving the proximal part of the stomach intact.
Department of Surgery, Sahlgren's Hospital, University of Gothenburg, Sweden.
B
B
Berglund
B
B
Liedman
L
L
Olbe
L
L
Lundell
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004946:Esophagostomy; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy; D007583:Jejunum / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011312:Pressure; D013270:Stomach / Q000503:physiopathology*