Durable Flap-Valve Mitigation of Duodenogastric Reflux, Remnant Gastritis and Dumping Syndrome Following Billroth I Reconstruction

作者：Hoya Yoshiyuki^*; Taki Tetsuya; Watanabe Atsushi; Nakayoshi Tomoko; Okamoto Tomoyoshi; Mitsumori Norio; Yanaga Katsuhiko

来源：Journal of Gastrointestinal Surgery, 2016, 20(4): 772-775.

DOI：10.1007/s11605-015-3022-x

• Billroth I
• Remnant gastritis
• Duodenogastric reflux
• Dumping syndrome
• New technique
• Pylorus reconstruction

We have reported the short-term results of pylorus reconstruction gastrectomy (PRG) that prevents duodenogastric reflux (DGR) and remnant gastritis after distal gastrectomy. We herein report the long-term results of the PRG.
PRG was performed in 37 patients (age 31 to 86 [mean 67.8 +/- 12.3] years, male:female = 22:15) with gastric cancer from June 2006 through December 2013. We examined the long-term outcome in 28 patients (age 41 to 86 [mean 67.0 +/- 10.7] years, male:female = 18:10) that passed over 3 years after surgery (LTR 44.1 +/- 11.7 months), and compared with their short-term result after the operation (STR 13.1 +/- 6.9 months). The adverse events of gastric surgery evaluated in this study consisted of the degree of remnant gastritis, the presence of dumping syndrome, and degree of weight loss (%).
There was no difference in the degree of DGR and remnant gastritis by gastroscopic finding between LTR and STR after PRG (P = 0.21). Statistically, there was no difference in the bile acid concentration of remnant gastric juice between LTR and STR (108.4 +/- 254.1 vs. 94.0 +/- 208.6 mu mol/L, P = 0.33), and weight loss of LTR was the same as that of STR (5.67 +/- 7.08 vs. 4.59 +/- 5.63 %, P = 0.34). There were few morphological changes in the reconstructed pylorus by the long-term course, but 2 patients showed mild atrophy.
The form of reconstructed pylorus and the effect that reduces side effects of Billroth I seem to last for a long time.

• 出版日期2016-4