Total gastrectomy: the influence of preserved duodenal transit and of pouch reconstruction on abdominal symptoms, nutrient assimilation, and medico-social functioning.

BACKGROUND/AIMS: The aim of this retrospective study was to establish whether patients with different reconstruction after total gastrectomy (duodenal bypass without pouch (subgroup Ia, n = 88); duodenal bypass with pouch (subgroup Ib, n = 27); continuous duodenal transit (subgroup II, n = 27)) differ concerning abdominal symptoms, nutrient assimilation, and medico-social functioning. METHODS: The 142 patients (49 females, 93 males; mean age 57.2 years, (95% confidence interval 55 to 59)) after potentially curative total gastrectomy for gastric malignancy 500 days earlier (mean: 95% confidence interval 334 to 666) were evaluated for abdominal symptoms, biochemical and haematological parameters, endoscopic findings, small intestinal bacterial overgrowth, oro-caecal transit time, objective signs of malassimilation, and the degree of medico-social functioning. RESULTS: There were no significant differences between the subgroups in any of the parameters examined. CONCLUSION: In this study, neither subjective nor objective patient data support preference for any single mode of the examined reconstructions after total gastrectomy. However, small patient numbers, unstandardised reconstruction procedures and a recruitment bias might influence these findings.