The influence of reconstruction methods on food retention phenomenon in the remnant stomach after a subtotal gastrectomy

J Surg Oncol. 2008 Jul 1;98(1):11-4. doi: 10.1002/jso.21076.

Abstract

Background and objectives: Food retention and bile reflux has been frequently observed in gastric cancer patients following a subtotal gastrectomy. The aim of this study was to determine whether reconstruction methods after the distal subtotal gastrectomy influenced the degree of food residue and bile reflux.

Methods: The prospectively collected data was reviewed retrospectively for 522 patients with early gastric cancer who had undertaken a follow-up endoscopic examination after a distal subtotal gastrectomy between 2003 and 2006.

Results: The incidence of food retention was 55.5%, 31.9%, and 20.9% at 3, 12, and 24 months after distal subtotal gastrectomy, respectively. The food residue score was higher in the Billroth I (stapling) group than the Billroth II (hand sewing) group at 3 months after surgery (P = 0.006). The incidence of bile reflux was higher in the Billroth II group than in the Billroth I group at 12 and 24 months after surgery (P < 0.001, P = 0.002, respectively). No significant association was found between the food retention and body weight changes.

Conclusions: Food retention was detected in lots of patients after subtotal gastrectomy and the reconstructive methods after subtotal gastrectomy was not relevant to food retention.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Reflux / etiology
  • Bile Reflux / physiopathology
  • Female
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods*
  • Gastric Emptying*
  • Gastric Stump / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Postgastrectomy Syndromes / etiology
  • Postgastrectomy Syndromes / physiopathology
  • Postgastrectomy Syndromes / prevention & control*
  • Retrospective Studies
  • Stomach Neoplasms / surgery
  • Sutures