Assessment of the Gastro-Jejuno-Duodenal Transit After Jejunal Pouch Interposition

Abstract

Background : The jejunal pouch interposition between the gastric body and the duodenum after the gastrectomy, although not frequent in the surgical practice today, has been successfully employed for the prevention and treatment of the postgastrectomy syndromes. In the latter, it is included the dumping syndrome, which affects 13-58% of the patients who undergo gastrectomy. Aim : Retrospective assessment of the results of this procedure for the prevention of the dumping syndrome. Methods : Fourty patients were selected and treatetd surgically for peptic ulcer, between 1965 and 1970. Of these, 29 underwent vagotomy, antrectomy, gastrojejunalduodenostomy at the lesser curvature level, and the 11 remaining were submitted to vagotomy, antrectomy, gastrojejunal-duodenostomy at the greater curvature level. The gastro-jejuno-duodenal transit was assessed in the immediate or late postoperative with the contrasted study of the esophagus, stomach and duodenum. The clinical evolution was assessed according to the Visick grade. Results : Of the 40 patients, 28 were followed with the contrast evaluation in the late postoperative. Among those who were followed until the first month (n=22), 20 (90%) had slow gastro-jejuno-duodenal transit and in two (10%) the transit was normal. Among those who were followed after the first month (n=16), three (19%) and 13 (81%) had slow and normal gastric emptying, respectively. None had the contrasted exam compatible with the dumping syndrome. Among the 40 patients, 22 underwent postoperative clinical evaluation. Of these, 19 (86,5%) had excellent and good results (Visick 1 and 2, respectively). Conclusions : The jejunal pouch interposition showed to be a very effective surgical procedure for the prevention of the dumping syndrome in gastrectomized patients.

Nutritional Aspects and the Use of Nutritional Supplements by Women Who Underwent Gastric Bypass

“…According to the comparative study of Faria et al 6 , regarding the Roux-en-Y gastric bypass with and without placing the containment ring, the use of gastric containment ring reduces the consumption of protein and fiber, favoring a lower incidence of vomiting. In the study of Silva e Gomes 17 there was found that the interposition of jejunal loop contributes to reduction in episodes of dumping syndrome in individuals that underwent gastrectomy.…”

A Importância Da Suplementação Proteica No Paciente Bariátrico

“…Tanto o pré quanto o pós operatório, imediato e tardio, são de extrema importância para o sucesso do tratamento. Nesse contexto, a frase "perda de peso de forma saudável" tem sido bem-empregada (MOREIRA; ESPÍNOLA; AZEVEDO, 2015;SILVA;GOMES, 2015).…”