Preservation of the Duodenal Passage after Gastrectomy After partial or total gastric resection the upper gastrointestinal tract is discontinued and the reservoir lost. These changes considerably impair the function of secretion – transport – digestion and may cause the post-gastrectomy syndrome. Besides the Roux-en Y reconstruction the duodenal passage is the other most important concept of reconstruction after total or partial gastric resection. Doubtlessly, the continuity of duodenal passage represents the physiological concept, although it is difficult to prove the long-term benefit for the patient. There are advantages for the fat and carbohydrate metabolism during the 1st year. On the other hand, 1 year after Roux-en Y reconstruction the mechanisms of compensation in the upper gastrointestinal tract provide good gastrointestinal function. The results of randomized studies for the continuity in duodenal passage are controversial. This implicates that the interposition of jejunum – presenting more difficulties – cannot be obligatory.

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© 2000 S. Karger GmbH, Freiburg
2000
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