Jejunal Interposition as Remedial Operation for Severe Dumping Syndrome

The remedial operation for the control of symptoms was carried out in 6 cases with severe dumping syndrome. Three male cases and 3 female cases were treated, and its age at the initial gastrectomy ranged from 24 to 64 years old, and 5 cases with gastric ulcer and 1 case with gastric cancer were observed as primary diseases. As the initial operative procedures, distal subtotal gastrectomy in 5 cases, distal hemigastrectomy in one case and Billroth II type anastomosis in 5 cases with gastric ulcer were performed, and 1 case with gastric cancer was reconstructed by Billroth I type anastomosis. Dumping symptom developed from 3 weeks to 1 month after gastrectomy in all cases except 1, and body weight loss due to labor disturbance and malnutrition was observed. They have been suffering from the syndrome for 3 to 27 years, and remarkable rapid transit of gastric contents was observed on both roentgenograph and gastric scintigram before surgery. As reoperation, the jejunum was interposed reversibly from 5 to 9cm between the gastric remnant and duodenum. Re-surgery was necessitated in 1 case, while improvement of symptoms was observed in the remaining cases, and reduction of the emptying time of gastric contents was observed by imaging diagnosis.