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CURRENT ISSUECHIRURGIA

A Journal on Surgery


Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index

 

Chirurgia 2006 April;19(2):123-8

 ORIGINAL ARTICLES

Hepatic-intestinal function after total gastrectomy and reconstruction by jejunal loop interposition. Double-isotope scintigraphic evaluation

Tocchi A. 1, Mazzoni G. 1, Scopinaro F. 2, Cassini D. 1, Liotta G. 1, Bettelli E. 1, Miccini M. 1

1 First Department of Surgery University of Rome “La Sapienza”, Rome
2 Department of Experimental Medicine Nuclear Medicine Section University of Rome “La Sapienza”, Rome

Aim. Reports on body weight behavior after total gastrectomy (TG) with maintained duodenal transit are conflicting because both weight loss and gain have been observed. The aim of this study was to investigate the choice of reconstruction procedure as a possible factor interfering with the nutritional status of patients treated by TG.
Methods. Clinical and demographic data of patients were recorded. The patients were then divided in two groups according to the percentage of weight recovery (groups A and B). A double-isotope scintigraphic study was performed by oral intake of fresh egg-white labeled with 111In and simultaneous intravenous administration of 99Tc dimethyl iminoacetic acid (HIDA). The progression of the labeled bile and meal were then judged as synchronous or asynchronous.
Results. During the 36-month study 24 patients were enrolled. The average weight recovery was 93.75% (SD±13.48%). No statistical difference was found by comparing the symptoms scores observed in the two groups. The synchronous matching of food with biliopancreatic juice was observed in 10 of 12 (83.3%) patients belonging to group A and in 2 of 12 (16.7%) patients of group B.
Conclusion. Maintenance of duodenal transit in restoring intestinal continuity represents a determinant factor in conditioning the postoperative nutritional behavior of patients undergoing TG.

language: English


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