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

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

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.

Patients and Methods

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 (%).

Results

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 μmol/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.

Conclusion

The form of reconstructed pylorus and the effect that reduces side effects of Billroth I seem to last for a long time.

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Acknowledgments

This study is partially founded by Japanese Society for Advancement of Surgical Techniques.

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Authors and Affiliations

  1. Department of Surgery, Daisan Hospital, The Jikei University School of Medicine, 4-11-1, Izumihon-cho, Komae-si, Tokyo, 201-8601, Japan

    Yoshiyuki Hoya, Tetsuya Taki, Atsushi Watanabe, Tomoko Nakayoshi & Tomoyoshi Okamoto

  2. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Norio Mitsumori & Katsuhiko Yanaga

Authors
  1. Yoshiyuki Hoya
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  2. Tetsuya Taki
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  3. Atsushi Watanabe
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  4. Tomoko Nakayoshi
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  5. Tomoyoshi Okamoto
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  6. Norio Mitsumori
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  7. Katsuhiko Yanaga
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Corresponding author

Correspondence to Yoshiyuki Hoya.

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Each patient enrolled in the study provided written informed consent.

Additional information

Long-term QOL improvement following PRG

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Hoya, Y., Taki, T., Watanabe, A. et al. Durable Flap-Valve Mitigation of Duodenogastric Reflux,  Remnant Gastritis and Dumping Syndrome Following Billroth I Reconstruction. J Gastrointest Surg 20, 772–775 (2016). https://doi.org/10.1007/s11605-015-3022-x

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  • DOI: https://doi.org/10.1007/s11605-015-3022-x

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