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Abstract
Post-gastrectomy complications have been the associated sequelae after curative gastrectomy for long time. They include a conundrum of symptoms ranging from serious metabolic alterations to disorders attributed to mechanical and neural factors after reconstruction of the digestive continuity. Though, with the advancement in the surgical expertise and techniques and shift towards medical and endoscopic management for benign gastro-duodenal ulcer disease, there has been a decline in the incidence of these complications; they continue to raise "red flags" after major oncologic gastric resections. Identification of these symptoms and protocol based management of the same is of utmost importance in the surgical armamentarium of trainees and practicing physicians and surgeons.
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2
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Barajas-Fregoso EM, Romero-Hernández T, Macías-Amezcua MD. [Acute pancreatitis and afferent loop syndrome. Case report]. CIR CIR 2013; 81:441-444. [PMID: 25125063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The afferent syndrome loop is a mechanic obstruction of the afferent limb before a Billroth II or Roux-Y reconstruction, secondary in most of case to distal or subtotal gastrectomy. Clinical case: Male 76 years old, with antecedent of cholecystectomy, gastric adenocarcinoma six years ago, with subtotal gastrectomy and Roux-Y reconstruction. Beginning a several abdominal pain, nausea and vomiting, abdominal distension, without peritoneal irritation sings. Amylase 1246 U/L, lipase 3381 U/L. Computed Tomography with thickness wall and dilatation of afferent loop, pancreas with diffuse enlargement diagnostic of acute pancreatitis secondary an afferent loop syndrome. CONCLUSION The afferent loop syndrome is presented in 0.3%-1% in all cases with Billroth II reconstruction, with a mortality of up to 57%, the obstruction lead accumulation of bile, pancreatic and intestinal secretions, increasing the pressure and resulting in afferent limb, bile conduct and Wirsung conduct dilatation, triggering an inflammatory response that culminates in pancreatic inflammation. The severity of the presentation is related to the degree and duration of the blockage.
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Affiliation(s)
- Elpidio Manuel Barajas-Fregoso
- Cirugía General, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, México DF, Mexico.
| | - Teodoro Romero-Hernández
- Servicio de Gastrocirugía, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, México DF, Mexico
| | - Michel Dassaejv Macías-Amezcua
- Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, México DF, Mexico
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Nakada K, Yanaga K, Omura N, Kawamura M, Konishi H, Iwasaki T, Mitsumori N, Hanyu N, Kashiwagi H, Oki T. [Improving the quality of life after gastrectomy is the next issue after saving the lives of patients with gastric cancer]. Nihon Geka Gakkai Zasshi 2012; 113:12-17. [PMID: 22413550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Gastrectomy saves the lives of many patients with gastric cancer. However, this surgical treatment is associated with clinical problems called postgastrectomy syndrome (PGS) which affect the quality of life (QOL) of such patients. For surgeons, improving the QOL after gastrectomy is an important goal after performing curative surgery. In the clinical setting, various surgical procedures such as limited resection, function-preserving procedures, and reconstruction using gastric substitutes have been advocated to reduce the severity of PGS. However, the actual conditions and pathophysiology of PGS have not been fully investigated. Various clinical studies and basic research have partially clarified the features and pathophysiology of PGS, although the strategies developed to treat PGS have been limited. The development of standardized, reliable instruments for understanding PGS and performing large-scale collaborative studies are required to improve the diagnosis and treatment of PGS. In Japan, such a project called the PGSAS has recently been completed. The results are being analyzed and will be reported in the near future.
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Affiliation(s)
- Koji Nakada
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
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4
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Ruchkina IN, Lychkova AE, Kuz'mina TN, Kostiuchenko LN. [Postgastrectomy syndromes in therapeutic practice ]. TERAPEVT ARKH 2011; 83:55-57. [PMID: 22416446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To specify policy of nutritive support late after radical gastric resection. MATERIAL AND METHODS Patients with postgastroresectional dystrophy were examined using standard techniques and estimation of intestinal electric activity (registration of body surface biopotentials on Conan-M myngograph). RESULTS Frequency-amplitude parameters of the intestine serve the basis for choice of mixtures for enteral correction. Nutritive support provided for on demand pharmaconutrients--microbiotic correctors. CONCLUSION Myography gives additional information for decisions on the policy of nutritive support.
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Kato T, Akiyama N, Motoyama H, Arai F, Inayoshi J, Funakoshi K. [Postgastrectomy syndrome and its management]. Nihon Naika Gakkai Zasshi 2005; 94:80-4. [PMID: 15685879 DOI: 10.2169/naika.94.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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6
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Abstract
The stomach has a variety of functions that are lost with gastrectomy. Since nowadays a significant number of patients are long-term survivors, consequences of this loss need to be considered by gastroenterologists and surgeons alike. Abnormal transit, disturbed general nutrition and micronutrient deficiencies are the most common problems. The main resulting symptoms are early and late dumping, reflux esophagitis, weight loss, anemia, and osteopathy. It is not definitively clear if pouch reconstruction can really improve the situation. Dietary measures, rarely re-operation, and in particular adequate follow-up of metabolic and nutrition parameters with consequent substitution are the main therapeutic necessities.
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Affiliation(s)
- Jürgen Schölmerich
- Department of Internal Medicine I, University Medical Center Regensburg, D-93042 Regensburg, Germany.
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7
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Schmidt-Matthiesen A, Weidmann R, Sänger P. [Longitudinal study on quality of life after gastrectomy for gastric cancer and starting points for intensified care]. Zentralbl Chir 2003; 128:304-8. [PMID: 12700987 DOI: 10.1055/s-2003-38794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED This prospective longitudinal study on gastric carcinoma patients with gastrectomy was designed to answer the question about changes in several determinants of the quality of life (QL) at various times before and after surgery and to obtain evidence for specific approaches of therapeutic intervention. METHODS AND PATIENTS 36 patients were given a questionnaire structured according to Eypasch et al. (self- assessment) before surgery, at discharge from the hospital, and after 3 and 6 months. The dual structure of the questions makes it possible to determine whether a single item is present at all (prevalence) and to what extent it impairs the quality of life (no impairment/some/moderate/strong impairment--corresponding to 0-3). The data were evaluated per domain of QL as well as item-related. RESULTS Postoperatively, 14 patients had to be excluded from the study because of non-radical surgery, complications, recurrences, etc. After 6 months the items of all QL-determinants showed the lowest prevalence with the exception, however, of the somatic determinants, the items of which showed a prevalence of 27 % preoperatively, 64 % at discharge from the hospital, 58 % after 3 months, and 46 % after 6 months. The average degree of QL-impairment increased continuously from 1.17 preoperatively to 1.61 after 6 months. Preoperatively the psychic domain was predominantly impaired, postoperatively the somatic domain. CONCLUSION Analysis of the subjective quality of life can reveal care deficits. Gastrectomy-associated symptoms seem to influence the quality of life considerably in the first 6 months after surgery. More attention has to be paid to the sequelae of surgery. The high pre- and postoperative frequency of psychic impairment makes it desirable to provide special psychooncological offers of care.
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Affiliation(s)
- A Schmidt-Matthiesen
- Klinik für Allgemein- und Gefässchirurgie, Klinikum der Johann Wolfgang Goethe-Universität.
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8
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Ohwada S, Nakamura S, Ogawa T, Izumi M, Tanahashi Y, Sato Y, Ikeya T, Iino Y, Morishita Y. Segmental gastrectomy for early cancer in the mid-stomach. Hepatogastroenterology 1999; 46:1229-33. [PMID: 10370697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND/AIMS We modified the surgical procedure for segmental gastrectomy, which is normally used for peptic ulcers, to treat early gastric cancer of the mid-stomach. In this paper, we describe the surgical technique and its results. METHODOLOGY The location of the tumor was confirmed by intra-operative endoscopic examination. An area 2 cm proximal and distal to the tumor was marked with sutures. Firstly, the lymph nodes were dissected from around the perigastric and along the left gastric and common hepatic arteries. Then, a segmental gastrectomy was performed. The greater omentum, omental sac, and vagal nerve, including the hepatic, pyloric and celiac rami, were left intact. An end-to-end gastrogastrostomy was performed using Gambee's sutures and 4-0 monofilament polydioxanone. Gastric drainage was not necessary. RESULTS We performed segmental gastrectomies on 30 patients. Tumors less than 1 cm in diameter were found in 4 patients; 1.1-2 cm in 14, 2.1-5 cm in 11, and a tumor exceeding 5.1 cm in one patient. The cancer was confined to the mucosa in 23 patients; in the other 7, it had penetrated the submucosa. No lymph node metastases were found but 2 patients had microscopic invasion or permeation of the lymphatic vessels. One patient required post-operative balloon dilation of the pyloric sphincter for delayed gastric emptying. The remaining patients had no post-operative complications. To date, 29 patients, excluding one who died in a traffic accident, have survived disease-free for a mean of 30 months (range: 7-51). Their body weight and dietary volume returned to pre-operative levels within 12 months of surgery. CONCLUSIONS Patients who underwent segmental gastrectomy have had a reasonably good quality of life in the post-operative follow-up to date.
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Affiliation(s)
- S Ohwada
- Second Department of Surgery, Gunma University School of Medicine, Showa-Machi, Japan.
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9
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Dietl KH, Senninger N. [Electric stimulation of the human stomach]. Z Gastroenterol 1998; 36:1095-7. [PMID: 10025060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- K H Dietl
- Westfälischen Wilhelms-Universität, Klinik und Poliklinik für Allgemeine Chirurgie, Münster
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10
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Kawamura H, Kuwabara Y, Mitani M, Sato A, Hattori K, Kataoka M, Fujii Y. Re: Resolution of acute afferent loop obstruction with percutaneous transhepatic drainage. Cardiovasc Intervent Radiol 1997; 20:481-2. [PMID: 9441003 DOI: 10.1007/s002709900199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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11
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Betaneli AM, Betaneli MA, Gedenidze DL. [Plasmapheresis and pain]. Vestn Khir Im I I Grek 1997; 156:120-21. [PMID: 9235753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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12
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Kirchner R. [Sequelae of stomach resection and gastrectomy and its consequences]. Z Gastroenterol 1996; 34 Suppl 2:20-3. [PMID: 8767414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- R Kirchner
- Chirurgische Klinik des Städtischen Krankenhauses Kemperhof in Koblenz
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13
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Smith RW, Kudsk K. Surgical and nutritional nightmares: what do we do now? Nutr Clin Pract 1996; 11:66-8. [PMID: 8788340 DOI: 10.1177/011542659601100266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- R W Smith
- Scott & White Clinic and Memorial Hospital, Temple, TX, USA
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14
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Kitajima M, Miyata M. [Management of post-gastrectomy disorders]. Nihon Geka Gakkai Zasshi 1994; 95:554-5. [PMID: 7838097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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15
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Donahue PE. Early postoperative and postgastrectomy syndromes. Diagnosis, management, and prevention. Gastroenterol Clin North Am 1994; 23:215-26. [PMID: 8070910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The evaluation and treatment of patients after operations on the foregut is a challenge for physicians and surgeons. The early postoperative period is an especially important interval because the very survival of the patient as well as the success of the surgical intervention depends on the correct interpretation of the presenting complaints. In all cases, a thoughtful and systematic approach allows physicians and surgeons to identify the causes and best remedies of these challenging problems.
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16
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Ritchie WP. Alkaline reflux gastritis. Gastroenterol Clin North Am 1994; 23:281-94. [PMID: 8070913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Alkaline reflux gastritis is a putative postgastrectomy syndrome presumably caused by excessive reflux of upper gastrointestinal content into the residual stomach after operations for peptic ulcer. In this article, the theoretic basis for the existence of such a syndrome is critically examined and found to be wanting in several respects. The diagnosis is therefore one of exclusion. Most nonoperative therapies are only modestly effective, with the possible exception of feeding patients ursodeoxycholic acid. When operation is indicated, the creation of a long-limb (45-cm) Roux-en-Y eliminates reflux. Unfortunately, symptoms are not invariably alleviated. Complications of operation include marginal ulceration and the Roux stasis syndrome.
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Affiliation(s)
- W P Ritchie
- Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania
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17
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Zemlianoĭ AG, Bugaev AI, Malkova SK. [The prevention and treatment of postoperative complications from gastrectomy for cancer]. Vestn Khir Im I I Grek 1994; 152:98-101. [PMID: 7701764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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18
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Podoluzhnyĭ VI, Fil'kov AP. [The digestive activity of the chymus in the gastric stump in postgastrectomy peptic ulcers]. Vestn Khir Im I I Grek 1992; 148:284-8. [PMID: 1302972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Forty-two patients with postgastroresection peptic ulcers of the zone of gastrojejunal anastomoses were examined. The cause of the appearance of the ulcers was the action of aggressive content of the gastric stump on the jejunum in the area of anastomosis. "Vagal" peptic ulcers were found by the gastrocepin test. After operations reducing the stump acidity healing of all the ulcers was noted. In achlorhydria of the stump the digestion in it is realized due to reflux at the expense of pancreas proteinases.
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Hirase N, Abe Y, Sadamura S, Yufu Y, Muta K, Umemura T, Nishimura J, Nawata H, Ideguchi H. Anemia and neutropenia in a case of copper deficiency: role of copper in normal hematopoiesis. Acta Haematol 1992; 87:195-7. [PMID: 1519434 DOI: 10.1159/000204758] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We present a patient who developed severe anemia and neutropenia after receiving parenteral nutrition for 2.5 years. The serum levels of copper and ceruloplasmin were low, and the bone marrow showed the presence of ringed sideroblasts and vacuolated immature cells. The administration of copper chloride by bolus injection led to a rapid improvement in anemia and neutropenia. The number of progenitor cells (colony-forming unit-granulocyte-macrophage and erythrocyte) present before the copper supplementation was well preserved. It is therefore suggested that copper enzymes play an important role in the maturation of hematopoietic cells.
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Affiliation(s)
- N Hirase
- Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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20
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Guadagni S, Pistoia M, Catarci M, Carboni F, Lombardi L, Carboni M. Retrograde jejunogastric intussusception: is endoscopic or surgical management more appropriate? Surg Today 1992; 22:269-72. [PMID: 1392333 DOI: 10.1007/bf00308834] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Jejunogastric intussusception (JGI) is a rare complication which can develop after partial gastrectomy, gastroenteroanastomosis or enteroanastomosis. Although its management is usually surgical, an endoscopic reduction can alternatively be attempted. We present herein a case of acute JGI in which failure of endoscopic reduction required surgical resection and reconstruction. This is followed by a discussion based on the current available literature.
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Affiliation(s)
- S Guadagni
- Department of Surgery, University of L'Aquila, Italy
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21
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Ortega Beviá JM, Jiménez García A, Naranjo Capitán M, Capitán Morales L, Rivera Hueto F, Vaquero Pérez MM, Pacheco García J, Segura Ramos R, Cantillana Martínez J. [Postoperative gastritis due to alkaline reflux. Our results]. Rev Esp Enferm Dig 1991; 80:365-9. [PMID: 1786182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We present the results of a retrospective study carried out on 23 patients with alkaline gastric reflux (AGR) verified through endoscopy, biopsies and Tc99m HIDA, which were operated on in our department with Y of Roux, Braun, Henley as the correction techniques of this pathology. The criteria of surgical indications were evaluated in these patients as also the results obtained in reference to residual symptoms and changes in the histologic and gammagraphic patterns.
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Affiliation(s)
- J M Ortega Beviá
- Departamento de Cirugía, Hospital Universitario Virgen de la Macarena, Sevilla
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Men'shikov VF, Korotkevich AG. [Endoscopic correction of cicatricial stenosis of the esophagus and esophago-intestinal anastomoses]. Vestn Khir Im I I Grek 1990; 144:99-100. [PMID: 2176013 DOI: pmid/2176013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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23
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Kazakov VA. [Stomach cancer]. Med Sestra 1990; 49:29-33. [PMID: 2377050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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24
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Russu G. [The clinical picture and therapy of postgastrectomy syndromes]. Rev Med Chir Soc Med Nat Iasi 1990; 94:257-64. [PMID: 2100831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
There is still much to learn about the cause of postgastrectomy syndromes. Fortunately, most patients can be managed by conservative measures unless a mechanical cause, amenable to operative correction, is found. Thus, it is important to determine the type of postgastrectomy problem that is affecting the patient. In carefully selected patients, remedial operations may ameliorate the patient's symptoms and permit him or her to return to a normal lifestyle. Humoral factors have attracted increasing attention, especially in patients with the dumping syndrome. The somatostatin analogue octreotide has provided relief from the vasomotor and gastrointestinal symptoms of severe dumping but must be given three to four times a day by injection.
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Affiliation(s)
- J L Sawyers
- Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232
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26
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Podil'chak MD. [Anastomositis after resection of the stomach and its treatment]. Khirurgiia (Mosk) 1989:120-2. [PMID: 2739285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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27
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Tatochenko KV, Sofronov VV, Abugov SA, Iurtsev VS. [Balloon dilatation in stenosis of esophagojejuno-anastomosis after gastrectomy]. Vestn Khir Im I I Grek 1988; 141:120-3. [PMID: 3232283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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28
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Babichev SI. [Biological problems of total gastrectomy]. Khirurgiia (Mosk) 1988:25-30. [PMID: 3419071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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29
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Shvarts VI, Iakushkina RE, Rassvetaeva GI, Khlebnikova LA, Kariakidi VK. [Effect of balneofangotherapy on the condition of the hepatobiliary system in patients with peptic ulcer after the operation on the stomach]. Vopr Kurortol Fizioter Lech Fiz Kult 1988:11-4. [PMID: 3400159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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30
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Hagège H, Cosnes J, Gendre JP, Le Quintrec Y. [Continuous enteral feeding of the gastrectomized patient with malnutrition]. Ann Gastroenterol Hepatol (Paris) 1987; 23:3-9. [PMID: 3107458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The development of nutritional parameters, anthropometric and biologic, under polymeric continuous gastro-intestinal feeding, was followed during 3 to 7 weeks in a group of 10 gastrectomised patients with malnutrition and compared with a group of 10 patients with malnutrition secondary to intake deficiencies and receiving the same treatment. Body weight, mid-arm muscle circumference, triceps skinfold and serum transferrin increased significantly from the beginning to the end of the gastro-intestinal feeding in both groups, and in a comparable fashion. Continuous gastro-intestinal feeding is therefore an effective treatment of malnutrition in the gastrectomised patient. The response obtained, as far as nutrition is concerned, may be compared to that of the patient with malnutrition secondary to intake deficiencies.
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Utkin VV, Ribenieks RR. [Diagnosis and treatment of postresection reflux gastritis]. Vestn Khir Im I I Grek 1985; 134:37-40. [PMID: 4013014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
An analysis of 78 patients with postresection reflux-gastritis after resection of the stomach for ulcer disease of the stomach and duodenum is presented. Of special significance for diagnosis is fiber gastroscopy with aimed biopsy. The conservative treatment was used in 74 patients, little effect was obtained in 19 of them. Four patients were operated on with V-shaped anastomosis after Roux. Results of the operations were good.
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Abstract
We wondered whether Roux gastrojejunostomy alone or with intestinal pacing would slow gastric emptying and ameliorate the dumping syndrome after truncal vagotomy and subtotal distal gastrectomy. In five conscious dogs with vagotomy and distal gastrectomy, the Roux loop alone slowed gastric emptying of 100 ml 5% glucose instillates, but not of 100 ml 25% glucose instillates, while pacing the loop backwards slowed emptying of both. Pacing also decreased the postcibal hemoconcentration and hyperglycemia found after the 25% instillates. However, pacing did not alter the postprandial hyper-GIP-emia (gastric inhibitory peptide) and hyperinsulinemia found in Roux gastrectomy dogs, suggesting that pacing worked by slowing emptying of glucose rather than by releasing enteric hormones. Although pacing did not stimulate jejunal action potentials (contractions), the greater the number of action potentials occurring during pacing, the more the slowing (r = .738, p less than .001). We concluded that the combination of Roux gastrojejunostomy and pacing ameliorated postgastrectomy dumping in dogs. The tests provide a basis for treating humans with postgastrectomy dumping.
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Agzankhodzhaev SM, Rakhmanov RK. [Early diagnosis and treatment of postgastrectomy jejunitis]. Vestn Khir Im I I Grek 1983; 130:41-4. [PMID: 6836854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Mitasov IG, Vygovskiĭ UP, Shevchenko SI, Shalduga VN, Sykal AS. [Diagnosis and treatment of the disturbances of evacuation from the gastric stump in the early postoperative period]. Klin Khir (1962) 1982:75-6. [PMID: 7132146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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36
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Typovský K. [The postoperative stomach. Review]. Rozhl Chir 1982; 61:291-309. [PMID: 7051359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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37
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Marcolli G, Confalonieri F, Guarneri A, Calzoni DA, Russo R, Santamaria A, Caccia F, Zucchi C. [Considerations on 7 years' experience in the use of total parenteral nutrition in the surgical department]. MINERVA CHIR 1982; 37:749-54. [PMID: 6808420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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38
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Langhans P. [Sequelae of the resection in peptic ulcer (author's transl)]. Leber Magen Darm 1982; 12:44-51. [PMID: 7047960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Clinical symptomatology of early and late sequelae after resective surgery in peptic ulcer may be dramatic or insidious; insidious changes for instance may occur in the gastric mucosa or they may be due to chronic deficiency of elementary dietary components. Loss of pylorus function and duodenal-gastric reflux are the most important causes for these symptoms.
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39
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Wada T, Yabana T, Fujii K. [Postgastrectomy syndromes]. Nihon Rinsho 1982; 40:1194-1204. [PMID: 6750178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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40
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Sveshnikov AI. [Gastrointestinal hemorrhage in patients with an operated stomach]. Vestn Khir Im I I Grek 1982; 128:60-4. [PMID: 6977909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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41
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Abstract
Seventeen cases of carcinoma of the stomach occurring late after previous gastric operation are presented. In all instances, patients had undergone gastroenterostomy, with or without gastric resection. Most patients had undergone the initial operation for peptic ulcer disease an average of 18 years before presenting with the tumor. Endoscopic biopsy of the gastroenterostomy and gastric cytologic evaluation offered a high degree of sensitivity and specificity in making the diagnosis. These tumors appeared to originate in the gastric mucosa near the stoma. Survival was poor with both curative and palliative therapy. Alkaline bile reflux, achlorhydria and bacterial colonization are discussed as possible causes. Patients who have undergone partial gastric resection are at increased risk for the development of carcinoma of the stomach remnant. We recommend that any patient in whom new upper gastrointestinal symptoms develop more than 10 hears after partial gastrectomy should undergo endoscopy with biopsy of the gastric mucosa adjacent to the anastomosis.
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Lubczyńska-Kowalska W, Cader J. [Conservative treatment of postgastrectomy syndromes]. Pol Tyg Lek 1981; 36:425-428. [PMID: 7267412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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43
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Avoian KM. [Outpatient care after gastric resection]. Med Sestra 1980; 39:12-4. [PMID: 6906575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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44
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Mansberger AR, Bowden TA. Continuing education examination: pre-test and post-test: treatment of postgastrectomy syndromes. Am Surg 1980; 46:270-1. [PMID: 7386993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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45
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Sawyers JL, Herrington JL. Treatment of postgastrectomy syndromes. Am Surg 1980; 46:201-7. [PMID: 7386983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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46
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47
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Shataliuk BP, Stetsenko GS, Khomenko NI, Grusha SI. [Treatment of patients with postresection disorders of the gastric function in conditions of a rural district]. Klin Khir (1962) 1979:63. [PMID: 502230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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48
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Neumayr A, Weiss W. [Pathogenesis, clinical manifestations and treatment of the "postgastrectomy-syndrome" (author's transl)]. Aktuelle Gerontol 1979; 9:257-63. [PMID: 37763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The incidence rate of complications in patients, who underwent stomach resection as surgical treatment procedure is rather high (20%). Postprandial syndromes (dumping syndrome, lactose-intolerance, afferent loop-syndrome), malabsorption syndromes (anemia, osteopathia, steatorrhea, protein deficiency) and late organic manifestations (anastomotic and suture ulcers, retrograde intussusception, gastric-stump carcinoma) were usually summarized as "postgastrectomy syndrome". A review of pathogenesis, symptoms and therapeutic approach for the various postoperative disorders is given. Selective proximal vagotomy as the surgical treatment procedure of choice is emphasized.
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49
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Amdrup E. [Stomach operation complications -- prevention and treatment]. Ugeskr Laeger 1979; 141:1157-8. [PMID: 442254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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50
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Hunt PS, Dowling J, Korman M, Hansky J. Bleeding stomal ulceration. Aust N Z J Surg 1979; 49:15-8. [PMID: 288421 DOI: 10.1111/j.1445-2197.1979.tb06429.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In a prospective study of patients with haematemesis and melaena, there were 22 admissions of patients with bleeding stomal ulceration, representing 2.5% of total admissions to the Unit. In 16 patients the bleeding was from superficial stomal lesions. These lesions, endoscopically and histologically, resembled alkaline reflux gastritis, a recently defined cause of postgastrectomy bile vomiting. Five patients presented with chronic ulceration following inadequate gastric surgery. One patient was admitted on two occasions. Nine patients received more than five units of blood and came to operation for continued bleeding. In seven of the surgical cases, the bleeding was from superficial stomal lesions. Our experience suggests that truncal vagotomy is necessary to control the bleeding in these patients. One patient presented with superficial stomal ulceration and carcinomatous change. This patient died. It is important to subject these lesions to biopsy, and biopsy with extension of a previous gastrectomy is indicated to control bleeding, and to exclude malignancy.
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