J.Jpn. Surg. Soc.. 98(6): 565-570, 1997

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Feature topic

A DEVICE IN RECONSTRUCTION METHOD AFTER DISTAL SUBTOTAL GASTRECTOMY SPECIAL REFERENCE TO DOUBLE TRACT METHOD WITH JEJUNAL POUCH

In the surgery of gastric cancer, it is necessary to consider not only the curability of gastric resection but also the quality of life of the patients in the choice of reconstruction method after distal gastrectomy. We have devised the jejunal pouch double tract method after gastrectomy. We reported in this study on the details of method and the satisfactory results.
We employed 15 cases of gastric cancer which should be resected over three quarters of the stomach because the tumor occupation were in the middle third of the stomach and wer expected long survival period. The operative procedure was as follows : (1) completion of gastric resection and lymph node dissection, (2) separation of jejunum at the site of 25 cm anal side from the Treitz’s ligament, (3) pulling up the anal side of the jejunum preparing double jejunal pouch with appoximately 10 cm in length using GIA, (4) anastomosis between residual stmach and jejunal pouch, (5) duodenojejunostomy at the site of 3-5 cm anal side from the pouch, (6) jejunojejunostomy at the site of 15cm anal side from the duodenojejunostomy. Double tract reconstruction with jejunal pouch after distal gastrectomy is wellbalanced method in the storage and discharging capacity, and useful in the view of better quality of life, especially in the cases which could be expected long survival period.

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