CASE REPORT   

Minerva Chirurgica 2000 July-August;55(7-8):523-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Restoration of the duodenal transit in surgical treatment of the postgastrectomy syndrome. Soupault Bucaille’s operation

Corsale I., Corsale C.

Between 5-50% of patients undergoing gastric resection still devolop postgastrectomy syndrome in spite of the development of surgical techniques and an improved knowledge of gastrointestinal physiopathology: unfortunately, 2-5% of these patients require surgery. The technique to be used depends on a careful clinical and instrumental evaluation aimed at identifying the dominant type of postresection syndrome and any associated lesions, on the previous operation and obviously on the intraoperative situation. Soupault-Bucaille's gastroduodenojejunoplasty aims to correct the postresection syndrome by reinserting the duodenum in the digestive circuit, interposing between it and the gastric stump a jejunal loop made from the efferent (or afferent in the case of Billroth II with efferent on the lesser gastric curvature). This reconstitutes a paraphysiological condition of the digestive circuit, reduces biliary reflux and resolves acute gastritis. It is indicated in patients affected by early or late Dumping syndrome, or multideficiency syndromes that do not respond to pharmacological therapy. The presence of concomitant biliary reflux is not a contraindication for this procedure, but confirms the need. Rouy-en-Y is able to produce better results in postgastrectomy syndromes with alkaline gastritis and/or esophagitis sustained by biliary reflux, gastric atonia and afferent loop syndromes.