J.Jpn. Surg. Soc.. 53(11): 889-897, 1953

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Original article

STUDIES ON METABOLISM, ESPECIALLY DIGESTION AND ABSORPTION AFTER TOTAL GASTRECTOMY.

Total gastrectomy deprives the body of all the important physiological functions of the stomach. The present investigation was undertaken to examine the state of digestion and absorption after total gastreotomy in comparison with that after partial gastrectomy and also to determine which mode of anastomosis should be preferred in total gastrectomy in order to improve postoperative digestion and absorption.
Results of the examinations have ascertained that digestion and absorption of protein and fat are more insufficient after total gastrectomy (particulary when esophago-jejunostomy was performed) than after partial gastrectomy. It is true that digestion and absorption are more or less improved after total gastrectomy when it has been so performed as to send food down through the duodenum instead of letting it pass direct into the jejunum : and yet, even in this case digestion and absorption are not so good as after partial gastrectomy (Billroth II) which allows food to pass through the jejunum after operation.
However, after total gastrectomy performed by TOMODA's method, wich whas devised with a view to compensating for the lost functions of the stomach by forming a substitute stomach, it has been found that toxic products, particularly phenols, as well as excreted fat are reduced in quantity, demonstrating the significance of the new operation mode as a measure of improving postoperative metabolism.
(author's abstract)

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