Regular Scintigraphic Measurements of Food Transit Following Different Types of Reconstruction After Total Gastrectomy

Hypothesis Ideal reconstruction after gastrectomy should ensure that the patient has a sufficiently large enteric reservoir to accommodate normal meals. Little is known about the transit of food after different methods of stomach reconstruction. The hypothesis of this trial was that food transit after gastrectomy is delayed by a pouch reconstruction compared with reconstructions without a pouch. Design Prospective. Setting University hospital. Patients and Methods A total of 27 patients underwent an interposition of a jejunal loop between the esophagus and the duodenum with (n=19) or without (n=8) a 7- or 15-cm proximal pouch reconstruction. Standardized scintigraphic measurements were performed to evaluate the food transit at fixed postoperative times. Main Outcome Measure Scintigraphically measured food transit time. Results The food transit time 1 year postoperatively was significantly prolonged in patients with the 15-cm pouch in comparison with those with the 7-cm pouch and those without a pouch reconstruction ( P =.005, P =.012). Patients with a pouch reconstruction tended to have better eating habits. Conclusions Our results confirm the hypothesis and suggest that interposition of a large 15-cm jejunal pouch can lead to a prolonged food transit time with enteric reservoir function resulting in better patient nutritional status.