It is well known that Roux-en-Y reconstruction is a good way to prevent duodenogastric reflux after subtotal gastrectomy. Most surgeons do not prefer to operate because of the problem of food retention.
We surveyed the incidence of food retention to the gastric carcinoma patients who had subtotal gastrectomy and reconstruction by Roux-en-Y method only during from August 1988 to July 1993 in 327 cases. We classified five groups according to the
length
of R-Y limb suture method : Group I is 30cm R-Y limb, Group II is 25cm R-Y limb, Group III is Tanner-19 method, Group IV is 25cm R-Y limb and Gambee stitches at posterior side of gastrojejunostomy, Group V is 25cm R-Y limb and Gambee stitches at
anterior and posterior side of gastrojejunostomy.
Food retention was assessed by gastroscope when they still staying at hospital and during folow up period. Degree of food retention was arbitrarily defined as following : Grade I; retention volume is 1-5ml, Grade 2;between Grade 1 and 3:
retention
volume is about one halft of the volume of gastrojejunal pouch, Grade 4;only a part of gastrojejunal pouch is visible, Grade 5;no part of gastrojejunal pouch is visible. We could perform this survey only 278 patients out of 327 because of
postoperative
death or missing the follow up. Grade 1, 2, 3, 4 and 5 was 69, 26, 11, 4 and 8 cases. The groups showing higher retention including Grade 3, 4 and 5 was about 8.3%(23cases) and improved to 7.2%(20cases) after 3 months. There was no cases of
retention
because of food retention but some of the problems could be managed by drugs.
Therefore, we conclusively suggest that Roux-en-Y reconstruction after subtotal gastrectomy for the gastric cnacer patients could be used safely. (Korean J Gastroenterol 1994 ; 26 : 83-89)
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