THE GASTROILEOILEAL POUCH - AN ALTERNATIVE CONTINENT URINARY RESERVOIR FOR PATIENTS WITH SHORT-BOWEL, ACIDOSIS AND OR EXTENSIVE PELVIC RADIATION

We report on 6 patients who underwent a new type of continent urinary diversion: the gastroileoileal reservoir. These are a select group of patients who presented with the short bowel syndrome, acidosis, border line diarrhea and/or severe pelvic radiation, which precluded the use of terminal ileum and the ileocecal segment. Considering these factors , and based on the different functional properties of the stomach as w ell as the need for a large reservoir, a segment of stomach and proxim al ileum was used to construct the reservoir. Four patients have been followed for at least 6 months, with the longest followup being 12 mon ths. Temporary dysphagia requiring hydrogen blockers developed in 1 pa tient. Results indicate excellent function of the continent urinary sy stem, lack of metabolic complications, absent diarrhea and excellent p atient tolerance. This procedure could be a useful alternative in some difficult clinical situations when continent urinary diversion is des irable.