Evaluation of Jejunal Pouch Interposition for Subtotal Gastrectomy

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 28; no. 8; pp. 1766 - 1770
• Main Authors: Matsumoto, Hisashi, Miwa, Koichi, Tsugawa, Koichiro, Segawa, Masataka, Sahara, Hiroyuki, Nakai, Masuo, Kinami, Shinichi, Fujimura, Takashi, Sugiyama, Kazuo, Nishimura, Genichi, Yonemura, Yutaka, Miyazaki, Itsuo, Aburano, Tamio
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 1995
• Subjects: jejunal pouch interposition; quality of life after gastrectomy; reconstruction method after subtotal gastrectomy
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.28.1766

The physical status of individuals after distal gastrectomy was evaluated in 74 patients with jejunal pouch interposition (JPI), 63 with Billroth I (B-I), and 41 with Billroth II (B-Il). Questionnaires revealed that the incidence of pyrosis and diarrhea was 5% (1/20) each in the JPI group, whereas it was 22% (7/32) and 31% (10/32), respectively, in the B-I, and 42% (5/12) and 75% (9/12) in the B-II group. This difference was significant. In RI scintigraphic study, the emptying time (T1/2) of the residual stomach was104±45 minutes in the JPI group, 29±6 in the B-I, and 50±37 in the B-II group. There was a significant difference between the JPI group and the other groups. Though labelled bile refluxed to the gastric remnant in all 4 and 3 patients with B-I and B-II, respectively, only 15% (2/12) of the patients with JPI had the regurgitation. The incidence of asynchrony between the bile and the food was 8% (1/12) in the JPI group, 25% (1/4) in the B-I group and 67% (2/3) in the B-II group. These data suggest that the JPI procedure improves the complaints after distal gastrectomy and gives the individual more physiological status than Billroth-type anastomosis.