Jejunal pouch length influences metabolism after total gastrectomy.
OBJECTIVE
To determine whether the length of the jejunal pouch used for reconstruction after total gastrectomy influences the postoperative metabolic and clinical outcome.


METHODS
Twenty-one patients who underwent total gastrectomy with long jejunal pouch reconstruction (length 20 cm: n = 9) or short jejunal pouch reconstruction (length 15 cm: n = 12) were studied. The volume of a single meal, clinical symptoms, glucose metabolism, and other metabolic parameters were studied.


RESULTS
Food intake, body weight, and dumping symptoms were similar in both groups, but the short pouch group had less reflux symptoms. Serum albumin and total cholesterol levels were higher in the short pouch group than in the long pouch group at 12 months postoperatively (p < 0.05). However, the short pouch group showed reduced glucose tolerance.


CONCLUSIONS
These findings suggest that jejunal pouch length might have a role in postoperative physiological status.
Tanaka
T
T
Second Department of Surgery, Hyogo College of Medicine, Japan.
Kusunoki
M
M
Fujiwara
Y
Y
Nakagawa
K
K
Utsunomiya
J
J
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis*; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D004377:Dumping Syndrome / Q000209:etiology; D004386:Duodenum / Q000601:surgery; D004435:Eating; D004947:Esophagus / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000534:rehabilitation; D005764:Gastroesophageal Reflux / Q000209:etiology; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007583:Jejunum / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000601:surgery
D001786:Blood Glucose; D001798:Blood Proteins; D007328:Insulin; D002784:Cholesterol; D005947:Glucose