Oida Takatsugu, Mimatsu Kenji, Kawasaki Atsushi, Kano Hisao, Kuboi Youichi, Amano Sadao
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama, 231-8553, Yokohama, Japan.
J Gastrointest Surg. 2009 Jul;13(7):1226-32. doi: 10.1007/s11605-009-0874-y. Epub 2009 Mar 31.
A gastroenterostomy is the most commonly performed palliative procedure in patients with gastroduodenal outflow obstruction (GOO) caused by unresectable advanced gastric and pancreatic cancer. We developed a new technique--modified Devine exclusion with vertical stomach reconstruction--and evaluated the efficacy of this procedure.
We retrospectively studied 60 patients who underwent gastrojejunostomy for GOO caused by unresectable advanced gastric and pancreatic cancer. These patients were divided into two groups, the conventional gastrojejunostomy group (CGJ group) and the modified Devine exclusion with vertical stomach reconstruction group (MDVSR group).
The mean duration of the required nasogastric suction, the number of days after which diet could be initiated and after which oral ingestion of solid food could by safely resumed, and the duration of hospitalization after the surgery were significantly shorter in the MDVSR group. The patients in the MDVSR group had a significantly longer duration of stay at home and survival after the surgery. Moreover, in the MDVSR group, GOO did not recur in any of the patients until the time of death.
We consider that our procedure of modified Devine exclusion with vertical stomach reconstruction is an easy and feasible technique for GOO.
胃十二指肠吻合术是因不可切除的晚期胃癌和胰腺癌导致胃十二指肠流出道梗阻（GOO）患者最常实施的姑息性手术。我们研发了一种新技术——改良迪瓦恩旷置术联合垂直胃重建术，并评估了该手术的疗效。
我们回顾性研究了60例因不可切除的晚期胃癌和胰腺癌导致GOO而接受胃空肠吻合术的患者。这些患者被分为两组，即传统胃空肠吻合术组（CGJ组）和改良迪瓦恩旷置术联合垂直胃重建术组（MDVSR组）。
MDVSR组所需鼻胃吸引的平均持续时间、开始饮食及安全恢复口服固体食物后的天数以及术后住院时间均显著缩短。MDVSR组患者术后在家停留时间和生存期显著延长。此外，在MDVSR组中，直至死亡时无一例患者出现GOO复发。
我们认为改良迪瓦恩旷置术联合垂直胃重建术是一种治疗GOO的简便可行技术。
