title: Jejunal interposition to prevent postgastrectomy syndromes.
abstract: BACKGROUND
  Postgastrectomy syndromes include reflux gastritis and oesophagitis, dumping syndrome, intractable diarrhoea and afferent loop syndrome. To prevent such syndromes, since January 1994 jejunal interposition has been used following distal gastrectomy. The aim of this study was to evaluate the benefit of this procedure.
  
  
  METHODS
  A consecutive series of 42 patients who underwent distal gastrectomy for gastric cancer was studied. Twenty-two patients had a Billroth I procedure before January 1994, and 20 patients had isoperistaltic jejunal interposition using a 10-12-cm segment after January 1994.
  
  
  RESULTS
  The mean operating time was 260 min for Billroth I and 352 min for jejunal interposition. No serious postoperative complications arose. Reflux gastritis occurred in 19 patients after Billroth I but in none after jejunal interposition. Five patients in the Billroth I group had complaints consistent with dumping syndrome, compared with none after jejunal interposition. The barium gastric emptying time was significantly shorter after Billroth I (mean(s.d.) 269(225)s) than after jejunal interposition (736(479) s) (P < 0.01).
  
  
  CONCLUSIONS
  Jejunal interposition prevented reflux gastritis and inhibited rapid gastric emptying. Postgastrectomy syndromes were effectively prevented by this reconstruction procedure.
authors.affiliation: Surgery Division, Arita Gastrointestinal Hospital, Oita, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Morii
authors.forename: T
authors.initials: T
authors.lastname: Arita
authors.forename: K
authors.initials: K
authors.lastname: Shimoda
authors.forename: K
authors.initials: K
authors.lastname: Yasuda
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.forename: M
authors.initials: M
authors.lastname: Inomata
authors.forename: S
authors.initials: S
authors.lastname: Kitano
mesh_terms: D000328:Adult; D000343:Afferent Loop Syndrome / Q000517:prevention & control; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001835:Body Weight; D004377:Dumping Syndrome / Q000517:prevention & control; D004941:Esophagitis / Q000517:prevention & control; D005260:Female; D005756:Gastritis / Q000517:prevention & control; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000517:prevention & control*; D013274:Stomach Neoplasms / Q000601:surgery*; D013577:Syndrome