THE SUCCESSFUL APPLICATION OF JEJUNAL INTERPOSITION FOR SEVERE DUMPING SYNDROME - REPORT OF A CASE

We report herein the case of a 76-year-old man with intractable dumpin g syndrome which had manifested itself 3 years after he underwent a ga stric resection and Billroth I reconstruction for a gastric ulcer. Des pite aggressive medical therapy by the time of admission, he had suffe red from disabling dumping symptoms for 9 years. In an attempt to reli eve these symptoms, a 15-cm segment of the jejunum was placed isoperis taltically between the lesser curvature of the remnant stomach and the duodenum, and a selective vagotomy was performed. The dumping symptom s that he had experienced preoperatively completely disappeared after the revisory surgery. Postoperatively, an upper gastrointestinal serie s demonstrated a large gastric pouch and slower gastric passage into t he small intestine than what was seen preoperatively, while gastric em ptying studies using the acetaminophen method also showed normal patte rns in both the early and late postoperative phases. Thus, we consider that this surgical procedure is a simple and effective way to inhibit rapid gastric emptying and to slow intestinal transit in the treatmen t of dumping syndrome.