Jejunal Pouch Double-Tract Reconstruction after Total Gastrectomy for Gastric Cancer

Yasuyuki Kawachi, Takeaki Shimizu, Keiya Nikkuni, Atsushi Nishimura, Kazuhiko Tsunoda and Akira Iwaya

Department of Surgery, Nagaoka Chuo General Hospital

Purpose: We have been performing jejunal pouch double-tract reconstruction (PDT) to improve the QOL of patients after total gastrectomy, and this study examined the safety and efficacy of the PDT method. Method: The clinical results of the PDT method (72 patients) performed between May 2001 and March 2004 were compared with the results of the Roux-en Y method (R-Y) (84 patients) that was being performed conventionally. Results: PDT operation time was longer than R-Y operation time, but the difference was not significant. The overall frequency of postoperative complications of PDT and R-Y was almost the same. Complications regarding reconstruction occurred in 9.7% of the PDT cases, and 13.1% of the R-Y cases (not significant). Body weight one year after operation as a percentage of preoperative weight was 97.5% in the PDT group (40 patients) and 88.9% in the R-Y group (32 patients) and the increase in weight was better in the PDT group (p<0.05). There were no significant differences in the responses to a questionnaire about meals or in total cholesterol values, serum albumin values, or lymphocyte counts one year after the operation. Conclusions: PDT does not increase complications compared with R-Y; recovery of postoperative body weight is better; and PDT is concluded to be an effective procedure.

Key words
total gastrectomy, jejunal pouch, double tract reconstruction, Roux-en Y reconstruction

Reprint requests
Yasuyuki Kawachi Department of Surgery, Nagaoka Chuo General Hospital
2-1-5 Fukuzumi, Nagaoka, 940-8653 JAPAN

Accepted
December 17, 2004

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