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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2019, Vol. 13 ›› Issue (06): 593-595. doi: 10.3877/cma.j.issn.1674-3946.2019.06.016.

Special Issue:

• Original Article • Previous Articles     Next Articles

Observation and intervention of delayed gastric emptying after distal gastrectomy with gastric stump and jejunum double loop anastomosis for gastric cancer

mei Yang1, cailing Chen2,(), xiuyan Han2, min Yang2, dongmei Zhang2, haichun Xue2   

  1. 1. Neonatal Intensive Care Unit, Bayi Children’s Hospital, The Seventh Medical Center, General Hospital of PLA, Beijing 100700 , China
    2. Department of General Surgery, The Seventh Medical Center, General Hospital of PLA, Beijing 100700 , China
  • Received:2019-08-21 Online:2019-12-26 Published:2019-12-26
  • Contact: cailing Chen
  • About author:
    Corresponding author: Chen Cailing, Email:
  • Supported by:
    NationalNatural Science Foundation of China(30772188、30471700)

Abstract:

Objective

to investigate the clinical significance of management mode with five observation method and five intervention countermeasures of delayed gastric emptying after distal gastric cancer resection with gastric stump and jejunum double loop anastomosis.

Methods

The clinical effect of management mode with five observation method and five intervention countermeasures was analyzed retrospectively in the perioperative period among 129 cases of distal gastric cancer resection with residual stomach and jejunum double loop and side-side anastomosis by laparoscopic or laparotomy surgery.

Results

In 129 cases of distal gastric cancer resection, 93 cases were performed by laparoscopic surgery and 36 cases were performed by laparotomy surgery, all of which were successful. 11 cases (8.5%) were diagnosed with functional delayed gastric empting after surgery, 5 cases of which were relieved after treated with continuous gastrointestinal decompression and parenteral nutrition support therapy during7 to 21d, and 6 cases of which were placed the gastrointestinal nutrition tube into the distal jejunum over jejunum anastomosis measurement within 25 to 30 cm by using gastroscope, and through given comprehensive treatment with enteral nutrition support by the gastrointestinal nutrition tube, traditional Chinese medicine and psychological counseling everyday, the dysfunction of gastric emptying was relieved in 2 cases (18.2%) at 28 days and 1 case (9.0%) at 39 days and 2 cases (18.2%) at 43 days, and 1 case (9.0%) at 56 days. During this period, 4 cases (36.4%) with pulmonary infection were cured by anti-infection treatment, 6 cases(54.5%) with anxiety and depression were got control and anesis by psychological counseling and drug treatment. the dysfunction of gastric emptying was relieved in 11 cases, no case with reoperation of which was found and all of which were discharged from hospital upon recovery.

Conclusion

The good clinical effect was obtained by using the management mode with five observation method and five intervention countermeasures for delayed gastric emptying of distal gastric cancer resection with residual stomach and jejunum double loop anastomosis by aparoscopic or laparotomy surgery. It should be popularized and applied in clinical.

Key words: Stomach neoplasms, Laparoscopy, Postgastrectomy syndromes, Observation

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