Evaluation of Jejunal Pouch Interposition for Subtotal Gastrectomy

Hisashi Matsumoto, Koichi Miwa, Koichiro Tsugawa, Masataka Segawa, Hiroyuki Sahara, Masuo Nakai, Shinichi Kinami, Takashi Fujimura, Kazuo Sugiyama, Genichi Nishimura, Yutaka Yonemura, Itsuo Miyazaki, Tamio Aburano*

Second Department of Surgery, Kanazawa University School of Medicine
*Department of Radiology, Asahikawa Medical College

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-II). 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 (T_1/2) of the residual stomach was 104 ± 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 I5% (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.

Key words
jejunal pouch interposition, reconstruction method after subtotal gastrectomy, quality of life after gastrectomy

Reprint requests
Hisashi Matsumoto Department of Emergency and Critical Care Medicine, Nippon Medical School
1-1-5 Sendagi, Bunkyo-ku, Tokyo 113 JAPAN

Accepted
May 17, 1995

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