title: [Restoration of duodenal transit in the surgical treatment of postgastrectomy syndrome. The Soupault-Bucaille procedure].
abstract: Between 5-50% of patients undergoing gastric resection still develop postgastrectomy syndrome in spite of the development of surgical techniques and an improved knowledge of gastrointestinal physiopathology: unfortunately, 2-5% of these patients require surgery. The technique to be used depends on a careful clinical and instrumental evaluation aimed at identifying the dominant type of postresection syndrome and any associated lesions, on the previous operation and obviously on the intraoperative situation. Soupault-Bucaille's gastroduodenojejunoplasty aims to correct the postresection syndrome by reinserting the duodenum in the digestive circuit, interposing between it and the gastric stump a jejunal loop made from the efferent (or afferent in the case of Billroth II with efferent on the lesser gastric curvature). This reconstitutes a paraphysiological condition of the digestive circuit, reduces biliary reflux and resolves acute gastritis. It is indicated in patients affected by early or late dumping syndrome, or multi-deficiency syndromes that do not respond to pharmacological therapy. The presence of concomitant biliary reflux is not a contraindication for this procedure, but confirms the need. Roux-en-Y is able to produce better results in postgastrectomy syndromes with alkaline gastritis and/or esophagitis sustained by biliary reflux, gastric atonia and afferent loop syndromes.
authors.affiliation: Scuola di Specializzazione in Chirurgia Generale, Facoltà di Medicina e Chirurgia, Seconda Università degli Studi, Napoli.
authors.forename: I
authors.initials: I
authors.lastname: Corsale
authors.forename: C
authors.initials: C
authors.lastname: Corsale
mesh_terms: D004377:Dumping Syndrome / Q000209:etiology / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D018530:Gastric Stump / Q000601:surgery*; D005769:Gastrointestinal Motility; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000601:surgery*