Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Gastrectomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources

[Problems of esophagojejunal anastomosis following gastrectomy].

Experiences with 76 patients with esophagojejunoplication after total gastrectomy are reported. Clinical results are compared with a control group of 33 patients who underwent gastrectomy followed by terminolateral esophagojejunostomy as we did formerly. Performing this method of esophagojejunoplication the rate of leakage (2/76 respectively 3/33) of the anastomosis was reduced as well as the occurrence of reflux complaints (9/62 respectively 15/21).

Adult↗

[Syndromes following resection and gastrectomy].

Surgical therapy of carcinoma of the stomach has to take into consideration the individual type and localization of the tumor. Total gastrectomy as a therapeutical principle must be rejected. The syndromes after partial resection are less inconvenient than after total gastrectomy. A resection in combination with a reflux-free Roux-en-Y anastomosis should be preferred. After partial resection prophylactic therapeutic measures are not indicated. Continuous postoperative supervision is necessary however. Reoperations after a preceding partial resection are successful in many cases. The fate of the patient and the five-year survival rate depend directly on the stage of the tumor at the time of operation. Palliative operations improve expectation and comfort of life of the patient with an incurable carcinoma.

Esophagitis↗

Migrating myoelectric complex and jejunal slow-wave propagation after Roux gastrectomy in dogs.

Roux-en-Y gastrectomy is associated with a high incidence of symptoms of gastric stasis. Retrograde propagation of jejunal electrical slow waves and spike bursts has been implicated in the Roux Y stasis syndrome. Since the fasted state may persist after feeding, this study examined the extent of retrograde slow-wave propagation in the fasted state, particularly during aboral migration of phase III. Six dogs underwent Roux gastrectomy and placement of bipolar electrodes along the Roux limb. Four normal dogs with electrodes acted as controls. Thirty-five migrating myoelectric complexes were recorded in Roux dogs and 13 in controls. In Roux dogs, the incidences of retrograde propagation of slow waves during the migrating myoelectric complex were phase I 56 +/- 13%, phase II 60 +/- 12% and phase III 58 +/- 14% (not significant). For controls, the incidences were 0%, 0%, and 1%, respectively (P < 0.006 versus Roux dogs). In the Roux limb, retrograde propagation of slow waves, and hence spike bursts, occurs even during aboral migration of phase III. This abnormality may contribute to the Roux Y stasis syndrome.

Anastomosis, Roux-en-Y↗

Diazepam absorption: effects of age, sex, and Billroth gastrectomy.

The kinetics of diazepam absorption were assessed in 37 healthy volunteers, aged 19--79 years, who ingested a single 5-mg tablet in the fasting state. Diazepam plasma concentrations were measured by gas chromatography in multiple samples drawn over the next 72 hr. After a lag time averaging 12 min elapsed between tablet ingestion and the start of absorption, first-order absorption proceeded with a mean half-life of 19 min (range: 0--96 min), with peak plasma concentrations reached 0.9 hr after dosage (range: 0.25--2.5 hr). Age and sex did not influence absorption kinetics. Peak plasma concentrations averaged 157 ng/ml, and tended to be higher in women than in men because of lower body weights in women. Peak levels also declined with age, probably due to increased volume of distribution of diazepam in the elderly. Absolute systemic availability of oral diazepam was evaluated in seven of the subjects who received intravenous diazepam on another occasion. Based on areas under the oral versus intravenous plasma concentration curve, bioavailability of diazepam averaged 97%. Six male patients, at least 2 years after undergoing Billroth gastrectomy, also participated in the diazepam absorption study. Absorption kinetic parameters were nearly identical to those in six healthy age-matched male volunteers without gastrointestinal disease. Thus absorption of oral diazepam in the fasting state is rapid and nearly complete, and is minimally influenced by age, sex, or Billroth gastrectomy.

Administration, Oral↗

[Gastrectomy de nécessité].

According to the principle "gastrectomie de nécessité" a total gastrectomy may have to be performed when the distance between the proximal edge of the tumour and the cardia is less than an adequate margin of security. The main reason for advocating this principle is that a large number of patients (ca. 20%) can profit by the advantages of a partial resection above all concerning the nutritional status and the quality of life. Against this principle it is argued that in the presence of a diffuse type carcinoma the risk of local recurrence is considerably higher.

Follow-Up Studies↗

Paradoxical response to cerulein on sphincter of Oddi in the patient with gastrectomy.

Sphincter of Oddi motility was measured in 55 gallstone patients either through the sinus tract of percutaneous transhepatic biliary drainage or through the T tube. The influence of cholecystectomy and gastrectomy on the sphincter of Oddi was analyzed by comparing responses in patients with or without surgery to the administration of cerulein and the ingestion of dry egg yolk. When comparing cholecystectomized patients to nonsurgical subjects, cholecystectomy revealed no influence on the response to cerulein and feeding. Both groups showed relaxation of contraction waves after provocations. On the other hand, two thirds of the postgastrectomy patients showed an acceleration in the contractions of the sphincter of Oddi after provocations (one third showed no change), while all of the nongastrectomy group saw the disappearance of the wave after cerulein administration and 83% revealed complete suppression of the wave after feeding. It is suspected that this paradoxical response to CCK on the sphincter of Oddi is a lithogenic factor after gastrectomy.

Ceruletide↗

[The effect of antrectomy or total gastrectomy on calcium-induced gastrin secretion and gastrin release in man (author's transl)].

The effect of induced hypercalcemia on serum gastrin concentrations, measured by radioimmunoassay, and gastric acid secretion was studied in 20 healthy subjects, 8 patients after antrectomy and gastroduodenostomy (Billroth I), 12 patients after antrectomy and gastrojejunostomy (Billroth II) and in 9 patients after total gastrectomy and esophagojejunostomy. In normal man calcium stimulates gastric secretion and gastrin release. After antrectomy gastric secretion is still stimulated by calcium without changing serum gastrin levels. After total gastrectomy basal serum gastrin concentration is further reduced; calcium does not liberate gastrin. These results show that calcium-induced gastric secretion is caused by direct action at the parietal cell level besides the gastrin release from the antrum. In man, extra antral gastrin cannot be released by induced hypercalcemia.

Adult↗

Non-Hodgkin's lymphoma of the gastric stump developing 9 years after a distal gastrectomy for a peptic ulcer: a case report and review of the literature.

We report herein the case of a 65-year-old man who developed non-Hodgkin's lymphoma of the gastric stump 9 years after undergoing a distal gastrectomy for a gastric ulcer. The patient presented with epigastric discomfort, and an upper gastrointestinal series and gastroscopy revealed a lymphoma lesion located close to the site of his gastroduodenal anastomosis. A total gastrectomy was performed, followed by combination chemotherapy, comprised of vincristine, Endoxan, prednisone and Adriamycin (VEPA). Histologically, the resected specimen was diagnosed as non-Hodgkin's lymphoma. The patient has remained well without any signs of recurrence for 18 months since his operation. Although there have been a number of reports of adenocarcinoma developing in the gastric stump following surgery for peptic ulcers, the development of malignant lymphoma under such conditions is rare. Following the presentation of this case, we review the available literature and discuss the possibility of malignant lymphoma developing in the gastric stump.

Aged↗

Experimental study of pylorus and pyloric vagus preserving gastrectomy.

In an attempt to prevent the sequelae of conventional gastrectomy, such as rapid gastric emptying, dumping syndrome, intestinal content reflux, indigestion, and poor absorption, we have devised the pylorus and pyloric vagus preserving gastrectomy (PPVPG). Experimenting on 48 dogs, we found theoretic grounds for using our design and obtained the desired effects--retaining the merits of conventional subtotal resection of the stomach, with acidity reduction, while avoiding the above-mentioned complications.

Animals↗

Aberrant left hepatic artery arising from the left gastric artery and liver function after radical gastrectomy for gastric cancer.

An aberrant left hepatic artery, arising from the left gastric artery (LHLG), either as an accessory or replacing the left hepatic artery, is occasionally seen in patients with gastric cancer. Resection of LHLG, as part of the gastrectomy procedure, may cause liver dysfunction. The surgical records of a group of 141 patients who had undergone gastrectomy for gastric cancer following preoperative angiography were reviewed. Twenty-eight of the patients had an LHLG preoperatively; in 15 the artery was severed during surgery and in the remainder it was preserved. Postoperative liver function was assessed by measuring changes in lactate dehydrogenase, glutamic oxaloacetic transaminase, and glutamic pyruvic transaminase activities. The greatest changes in liver function were observed in patients in whom the LHLG has been severed; the changes in liver function among patients whose LHLGs were preserved were similar to those in patients who had no LHLG. Notably, the wider the area fed by the LHLG, the greater was the change in liver function. The observed liver dysfunctions were transient, however, and normal function resumed within 7 days after operation.

Adult↗

Experimental studies of reflux esophagitis following total gastrectomy in rats-pathogenesis and treatment.

Reflux esophagitis was successfully produced in all rats operated on by total gastrectomy and esophagojejunostomy. Its histopathological features comprised erosion and ulceration associated with inflammatory cell infiltration, with hyperplasia of the mucosal epithelium in some animals. These rats were dosed with sodium polyacrylate for protecting the mucosal surface, underwent jejunal diversion for preventing the reflux of digestive juice, or were treated with both in combination, to observe the repairing status of the esophageal ulcer, using the ratio of the length of the regenerated epithelium in the ulcer to the length of the ulcer as the index for the degree of repair. The oral ingestion of 5% sodium polyacrylate solution in drinking water proved the most effective means of administration of this agent. The repair was more improved greater in the group undergoing jejunal diversion, and was greatest in the group receiving both in combination. From these findings, oral administration of a mucosal surface protector, sodium polyacrylate, is an effective therapeutic regiment in mild cases of reflux esophagitis following total gastrectomy, as well as elimination of the cause by diversion of the route in severe cases. The combination of the two therapies will probably by the most effective therapeutic means for this disease.

Acrylic Resins↗

Gastric diverticula following subtotal gastrectomy.

Four cases of gastric diverticula following subtotal gastrectomy are described. This type of diverticula associated with partial gastrectomy are probably true, acquired, pulsion diverticula. In two of our patients the diverticula were associated with significant prolapse of gastric mucosa causing obstruction at the anastomosis.

Adult↗

Calcium regulating hormones and bone mineral content in patients after subtotal gastrectomy.

Twenty-nine men who had undergone Billroth I gastrectomy and 19 men who had undergone Billroth II gastrectomy were studied to examine the changes in their calcium regulating hormones and bone mineral content following surgery. The serum calcium and phosphate concentrations in the patients with Billroth I and Billroth II were normal. The Billroth II group had an elevated level of serum alkaline phosphatase and reduced bone mineral content. The 24,25(OH)2D concentration was reduced (P < 0.01) and 25(OH)D and 1,25(OH)2D concentrations were increased (P < 0.01, P < 0.05, respectively) in the Billroth II group. It was suggested by our study that the Billroth II patients had a reduced bone mineral content and an elevated 1,25(OH)2D concentration. Therefore, the pathophysiology of postgastrectomy bone metabolic disease is not due to vitamin D deficiency, but may instead be due to reduced calcium absorption in the intestine.

Aged↗

Gastrectomy in siblings with Christmas disease (hemophilia B).

Gastrointestinal hemorrhage is regarded as one of the commonest clinical manifestations of classic hemophilia and Christmas disease. Although major surgery is usually avoided in such cases, recently we had 2 cases of Christmas disease in siblings who had undergone a successful gastrectomy and concomitant administration of a concentrated preparation of factor IX. In addition, findings in 7 other Japanese patients with hemophilia who underwent gastrectomy are discussed.

Blood Transfusion↗

Bone lesions and dental caries after gastrectomy--evaluation of milk intolerance and operative procedure.

We investigated the development of bone lesions and dental caries in 350 patients who had undergone gastrectomy during the 11 year period from 1968 to 1978, on the basis of bone mineral content (BMC), decayed missing and filled (DMF) teeth and urinary c-AMP. We found that patients with low BMC and incidence of DMF teeth increased in number during the postoperative years; These abnormalities were, in comparison to the Billroth-I (B-I) and milk intake groups, significant in the Billroth-II (B-II) and non-milk intake groups. Among the gastrectomized patients, those with increased DMF teeth had significantly higher contents of urinary c-AMP. The possibility that secondary hyperparathyroidism resulting from gastrectomy contributes to the development and incidence of dental caries has to be given consideration.

Adolescent↗

Development of an ulcer in the side-to-side anastomosis of a jejunal pouch after proximal gastrectomy reconstructed by jejunal interposition: report of a case.

We present herein the first reported case of a deep ulceration developing in the pouch of a jejunal side-to-side anastomosis following the interposition of a jejunal U-shaped pouch (jejunal pouch), performed as reconstruction. A 47-year-old woman underwent a proximal gastrectomy and interposition of a jejunal pouch for early gastric cancer, 4 months after which she began to develop a fever. Esophagogastroscopy revealed a deep ulceration in the side-to-side anastomosis of the jejunal pouch. Her serum gastrin level was much higher than the normal range, and 24-h monitoring of the intraremnant stomach pH revealed that it was below 7.0 at night. A peptic ulcer was thought to be one of the causes of the pouchitis. Due to the drug-resistant ulceration and fever, a reoperation was performed, in which the jejunal pouch and remnant stomach were removed and Roux-en-Y reconstruction was done. There were no postoperative complications, and the fever resolved after surgery. Reconstruction of the jejunal pouch after proximal gastrectomy is recommended from the standpoint of quality of life (QOL); however, further studies on the size of the remnant stomach and the length of the interposed jejunal pouch are necessary.

Duodenal Ulcer↗

Laparoscopic-assisted proximal gastrectomy for early gastric carcinomas.

Laparoscopic-assisted proximal gastrectomy was performed in two Japanese patients with early gastric carcinomas located in the gastric cardia. The lower esophagus and upper stomach was divided under the pneumoperitoneum and resected via a minilaparotomy through an incision, 5 cm long, made in the epigastric area. The distal esophagus was anastomosed to a gastric tube made by resecting the lesser curvature of the stomach with a linear auto-stapler. Both patients recovered quickly without any postoperative complications, such as esophagitis, developing during follow-up periods of 3 and 6 months, respectively. Thus, we conclude that laparoscopic-assisted proximal gastrectomy and reconstruction with a gastric tube may be an effective method of treatment for patients with early gastric carcinomas located in the upper stomach in this era of minimally invasive surgery.

Cardia↗

Mechanisms of fat malassimilation following total gastrectomy in rats.

The present study is designed to elucidate the mechanisms of fat malassimilation following total gastrectomy. Using male Wistar rats, total gastrectomy with an esophagoduodenostomy was performed. Totally gastrectomized and normal control rats, provided with intestinal lymph fistula or closed intestinal loops with intact blood supply, were used for the absorption studies. The lymphatic absorption of the emulsion in the totally gastrectomized rats, administered into the duodenum, was significantly less than that in the control, administered into the stomach or duodenum. Fat assimilation in the totally gastrectomized rats was obviously disturbed. In the totally gastrectomized rats, the lymphatic absorption of the micelle was significantly higher than that of the emulsion. An examination of the lipid absorption in the closed intestinal loops, injected micellar solution, showed no differences between the control and totally gastrectomized rats in the lumen or wall recovery, while, the total esterified lipids in the intestinal mucosa from the ligament of Treitz to the cecum of the totally gastrectomized rats were significantly less than those of the control. These results suggest that postgastrectomy fat malassimilation is due to both an impaired micellar formation and the disturbed resynthesis of triglyceride from absorbed fatty acid and monoglyceride.

Animals↗