CLINICAL EVALUATION OF POSTOPERATIVE PANCREATIC FUNCTION AND COMPLICATION AFTER TOTAL GASTRECTOMY WITH BILLROTH-I AND BILLROTH-II RECONSTRUCTION

Abstract

The aim of this study is to evaluate postoperative pancreatic function and complications after total gastrectomy with reconstruction in 61 patients to clarify the features of reconstruction procedures, namely, jejunal interopsition (B-I group, 21 patients) and Roux en Y method (B-II gorup, 40).
The 75g oral glucose tolerance test (OGTT) performed in postoperative 2-3 months revealed that insulinogenic index during the first 30 minutes was 0.71±0.12 in B-I group versus 0.69±0.13 in B-II group, with no significant difference. Oral exocrine pancreatic function diagnostant test (PFD test) performed in post-operative 2-3 months revealed that the value (84.7±2.5%) in B-I group was significantly (p<0.05) better than that (78.7±3.5%) in B-II group. In B-II group there were much postoperative complications such as body weight loss, diarrhea and ileus compared with B-I group. These results suggest that jejunal interposition (B-I) which can make foods pass through the duodenum and upper jejunum is effective for quality of life after total gastrectomy compared with Roux en Y (B-II).