POSTGASTRECTOMY RECONSTRUCTIONS AND INTES TINAL MOTILITY

68 disease free patients were investigated prospectively after jejunal gastric replacement [jejunal interposition (JI): n=40; Roux en Y reco nstruction (RY): n=28]. Used function tests were: scintigraphic emptyi ng studies, hydrogene breath test, hepatobiliary sequential scintigrap hy, oral glucose tolerance test, and upper intestinal manometry with 5 measuring ports (times of investigation: 6.-12. week and >1 year post operatively). Patients with JI showed a better weight gain (p=0,001), a lower reflux rate (p=0,01), a slower orocecal transit time (p=0,05), a prompter bile flow after meal stimulation (p=0,02), and lower peak glucose levels (p=0,001). The emptying patterns of the different gastr ic substitutes were not different. A higher incidence of retrograde co ntractions in RY and a electromechanical coordination between duodenum and gastric substitute in JI were detected, We conclude that the post operative function of the jejunal gastric substitute does not depend o n it's emptying pattern or volume but on the motility patterns of the entire intestinal tract which seem to be strongly influenced by the ch oice of the jejunal reconstruction.