EXPERIMENTAL-STUDY ON THE VALUE OF A POUC H AFTER GASTRECTOMY

Aim of the study: Clinical relevant follow up parameters were used to examine the influence of an additional pouch for reconstruction after gastrectomy in Roux-en-Y technique and jejunal interposition in rats. Method: 3 months old rats were gastrectomized and reconstructed as fol lows: Roux-en-Y (RY n=50), jejunal interposition (JI n=55) and each of these combined with a jejunal J-pouch (RYP n=33; JIP n=26). Up to 9 m onths postoperatively body weight, hemoglobin, iron, total protein and amylase as well as the pouch volume and esophageal mucosa were follow ed up. Results: All gastrectomized animals show deficiencies compared to non operated controlls (n=6). The severity depends on the type of r econstruction. The RY group overall has the lowest values; hemoglobin (9 month) 4.2 g/dl, body weight (6 mon) 77 %, total protein (9 mon) 47 g/l. JI causes less defect: Hb (9 mon) 8.3 g/dl, BW (6 mon) 109 %, TP (9 mon) 61 g/l. Animals with additional pouch have better values than those with the similar type of reconstruction but without pouch; RYP: Hb (9 mon) 12.7 g/dl, BW (6 mon) 95 %, TP (9 mon) 55 g/l; JLP: Hb (9 mon) 15.1 g/dl, BW (6 mon) 107 %, TP (9 mon) 64 g/l. Hemoglobin and to tal protein do not significantly differ between the combination of int erposition and pouch and the control group (p greater than or equal to 0.05). The volume of the pouch increases 1:3 during 6 months. Animals with pouch do not show severe reflux esophagitis as do those without pouch.