Emptying of the jejunal pouch as a gastric substitute after total gastrectomy for cancer.
OBJECTIVE
The reservoir and transit capacity of the post-gastrectomy jejunal pouch was evaluated, using a radioisotopic method, to examine the relationship of the gastric emptying to postprandial symptoms and to the food intake status.


METHODS
Thirty-seven patients who had undergone total gastrectomy for cancer (Roux-Y reconstruction, 8; Hunt- Lawrence pouch and Roux-Y, 15; pouch interposition, 5; modified pouch interposition, 9) were retrospectively studied. Based on the percent retention in the gastric substitute, the emptying curves were classed as showing delayed, intermediate, and rapid emptying types.


RESULTS
All of the patients with pouch reconstruction showed either delayed or intermediate emptying. High frequency of the sensation of epigastric fullness, nausea, or vomiting was demonstrated in the patients with delayed emptying (p < 0.01). The patients with delayed emptying showed poor food intake compared to those with intermediate emptying (p < 0.05). Given the X-ray video film and endoscopic findings, the delayed emptying was thought to be due to poor drainage of the efferent loop resulting from the post-operative adhesions.


CONCLUSIONS
The present study revealed that delayed emptying is associated with postprandial symptoms and with poor food intake. The examination of gastric emptying is useful in evaluating or predicting the postoperative status.
Nakane
Y
Y
2nd Department of Surgery, Kansai Medical University, Osaka, Japan.
Akehira
K
K
Okumura
S
S
Okamura
S
S
Osawa
T
T
Okusa
T
T
Hioki
K
K
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004435:Eating; D005260:Female; D005743:Gastrectomy / Q000534:rehabilitation; D005746:Gastric Emptying; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery*