title: Risk factors for food residue after distal gastrectomy and a new effective preparation for endoscopy: the water-intake method.
abstract: OBJECTIVE
  Food residue is frequently observed in the gastric remnant after distal gastrectomy, despite adequate preparation. We devised a water-intake method to reduce food residue in the gastric remnant by drinking large quantities of water in a short time. The aims of this study were to identify the risk factors for food residue and to study the effectiveness of this new method for endoscopy preparation.
  
  
  METHODS
  A cohort of 708 patients who underwent distal gastrectomy for gastric cancer was reviewed prospectively. Sixty patients with large amounts of food residue were randomly divided into two groups: a water-intake group (n=40) and a prolonged fasting group (n=20).
  
  
  RESULTS
  The incidences of a large amount of food residue were 15.7%, 5.8%, 7.5%, and 2.8% at 3, 12, 24, and 36 months, respectively, after distal gastrectomy. Independent risk factors for food residue were endoscopy at 3 months, diabetes mellitus, a body mass index of <19.5, and laparoscopic surgery. The proportion of successful preparations at follow-up endoscopy was higher for the water-intake group (70%) than for the prolonged fasting group (40%, p=0.025).
  
  
  CONCLUSIONS
  The water-intake method can be recommended as a preparation for endoscopy in patients who have had repetitive food residue or risk factors after distal gastrectomy.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Cho
authors.forename: Kyoung-Won
authors.initials: KW
authors.lastname: Yoon
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Park
authors.forename: Wan-Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung-Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Rew