Iwata Takashi, Kurita Nobuhiro, Ikemoto Tetsuya, Nishioka Masanori, Andoh Tsutomu, Shimada Mitsuo
Department of Digestive Surgery, School of Medicine, Tokushima University, Tokushima, Japan.
Hepatogastroenterology. 2006 Mar-Apr;53(68):301-3.
BACKGROUND/AIMS: To prevent various distresses after proximal gastrectomy, reconstruction by interposed jejunal pouch has been advocated as an organ-preserving surgical strategy to ensure favorable quality of life for the patients.
Proximal gastrectomy was performed in 9 patients with gastric cancer in the upper third of the stomach. Four patients were randomly selected for reconstruction by jejunal pouch interposition (JPI group), while 5 had reconstruction by jejunal interposition (JI group). The patients who underwent JPI and JI were followed up to evaluate resumption of normal diet, change in body weight, and clinical symptoms.
The JPI group showed a significant dietary advantage. Three months after surgery, JPI patients could eat more than 80% of the volume of their preoperative meals, whereas JI patients ate less than 50%. The percentage of postoperative body weight loss was higher in the JI group than in the JPI group because the volume of the remnant stomach was more adequate in the latter. Moreover, it was easier to enter the remnant stomach and duodenum for endoscopic fiberscopy in the JPI group for the treatment of hepato-biliary pancreatic disease.
JPI is an effective method for preservation of gastric function after proximal gastrectomy.
背景/目的：为预防近端胃切除术后的各种不适，提倡采用空肠间置袋重建术作为一种保留器官的手术策略，以确保患者有良好的生活质量。
对9例胃上部三分之一处患胃癌的患者实施近端胃切除术。随机选择4例患者行空肠间置袋重建术（JPI组），5例患者行空肠间置重建术（JI组）。对接受JPI和JI手术的患者进行随访，以评估正常饮食的恢复情况、体重变化及临床症状。
JPI组在饮食方面具有显著优势。术后3个月，JPI组患者进食量可达术前饮食量的80%以上，而JI组患者进食量不足50%。JI组术后体重减轻的百分比高于JPI组，因为JPI组残胃容量更充足。此外，JPI组进行肝胆胰疾病内镜纤维检查时，进入残胃和十二指肠更容易。
JPI是近端胃切除术后保留胃功能的有效方法。
