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Jejunal interposition helps prevent reflux gastritis.
Hepatogastroenterology. 2002 Sep-Oct; 49(47):1461-4.H

Abstract

BACKGROUND/AIMS

Jejunal interposition after distal gastrectomy is reported to prevent both duodenogastric reflux and rapid gastric emptying. However, comparing primary reconstruction with this procedure and Billroth-I in terms of clinical evaluation by the same surgeon is rare. In this study, the benefit of this procedure was retrospectively evaluated as compared to the Billroth-I method.

METHODOLOGY

Of 30 patients with early gastric cancer located at the middle third of the stomach, 15 underwent distal gastrectomy with jejunal interposition and the other 15 underwent Billroth-I gastrectomy by the same surgeon. Isoperistaltic jejunal interposition measuring 10-12 cm was used. All the anastomoses without jejunojejunostomy were performed using auto-suture staplers. Assessment of postoperative symptoms and functions was performed one year after surgery.

RESULTS

The mean operation time was significantly longer after jejunal interposition (p < 0.01). No serious complications occurred in either group, and the hospital stay after operation was also similar. There were no significant differences in terms of postoperative symptoms, food intake, and recovery of body weight. The incidence of bile regurgitation and reflux gastritis was very low or zero in the jejunal interposition group, which indicated differences (p < 0.05, p < 0.01, respectively). Reflux esophagitis was not found in jejunal interposition, but two patients after Billroth I showed grade B esophagitis. As regards gastric emptying, the retention capacity was very poor and there was no significant difference between the two groups.

CONCLUSIONS

Jejunal interposition after distal gastrectomy was superior to the Billroth-I procedure in terms of reflux gastritis prevention. However, dumping syndrome and rapid gastric emptying were not prevented.

Authors+Show Affiliations

Second Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570, Japan. nakaney@takii.kmu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12239967

Citation

Nakane, Yasushi, et al. "Jejunal Interposition Helps Prevent Reflux Gastritis." Hepato-gastroenterology, vol. 49, no. 47, 2002, pp. 1461-4.
Nakane Y, Michiura T, Inoue K, et al. Jejunal interposition helps prevent reflux gastritis. Hepatogastroenterology. 2002;49(47):1461-4.
Nakane, Y., Michiura, T., Inoue, K., Habara, K., Nakai, K., Sato, M., Okumura, S., & Yamamichi, K. (2002). Jejunal interposition helps prevent reflux gastritis. Hepato-gastroenterology, 49(47), 1461-4.
Nakane Y, et al. Jejunal Interposition Helps Prevent Reflux Gastritis. Hepatogastroenterology. 2002 Sep-Oct;49(47):1461-4. PubMed PMID: 12239967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Jejunal interposition helps prevent reflux gastritis. AU - Nakane,Yasushi, AU - Michiura,Taku, AU - Inoue,Kentaro, AU - Habara,Kohzo, AU - Nakai,Koji, AU - Sato,Mutuya, AU - Okumura,Shunichiro, AU - Yamamichi,Keigo, PY - 2002/9/21/pubmed PY - 2003/1/24/medline PY - 2002/9/21/entrez SP - 1461 EP - 4 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 49 IS - 47 N2 - BACKGROUND/AIMS: Jejunal interposition after distal gastrectomy is reported to prevent both duodenogastric reflux and rapid gastric emptying. However, comparing primary reconstruction with this procedure and Billroth-I in terms of clinical evaluation by the same surgeon is rare. In this study, the benefit of this procedure was retrospectively evaluated as compared to the Billroth-I method. METHODOLOGY: Of 30 patients with early gastric cancer located at the middle third of the stomach, 15 underwent distal gastrectomy with jejunal interposition and the other 15 underwent Billroth-I gastrectomy by the same surgeon. Isoperistaltic jejunal interposition measuring 10-12 cm was used. All the anastomoses without jejunojejunostomy were performed using auto-suture staplers. Assessment of postoperative symptoms and functions was performed one year after surgery. RESULTS: The mean operation time was significantly longer after jejunal interposition (p < 0.01). No serious complications occurred in either group, and the hospital stay after operation was also similar. There were no significant differences in terms of postoperative symptoms, food intake, and recovery of body weight. The incidence of bile regurgitation and reflux gastritis was very low or zero in the jejunal interposition group, which indicated differences (p < 0.05, p < 0.01, respectively). Reflux esophagitis was not found in jejunal interposition, but two patients after Billroth I showed grade B esophagitis. As regards gastric emptying, the retention capacity was very poor and there was no significant difference between the two groups. CONCLUSIONS: Jejunal interposition after distal gastrectomy was superior to the Billroth-I procedure in terms of reflux gastritis prevention. However, dumping syndrome and rapid gastric emptying were not prevented. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/12239967/Jejunal_interposition_helps_prevent_reflux_gastritis_ L2 - https://antibodies.cancer.gov/detail/CPTC-HLA-B-1 DB - PRIME DP - Unbound Medicine ER -