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Diagnosis and treatment of postoperative gastroparesis:report of 25 cases

CAI Zhi min,LIU Quan da,YU Pei wu,et al. (Department of General Surgery,Southwest Hospital,the Third Military Medical University,Chongqing 400038,China)  
Objective To investigate the diagnosis and treatment of gastroparesis after abdominal surgery.Methods Undergoing surgical entities,clinical manifestations,diagnostic methods and therapeutic approaches of 25 cases of postoperative gastroparesis admitted in Southwest Hospital were analyzed retrospectively.Results Postoperative gastroparesis occurred frequently in those patients who having a long standing preoperative gastric outlet obstruction or malignant pathology,especially after performing the simple gastrojejunostomy without gastric resection or pancreatico duodenectomy.Endoscopy,upper gastrointestinal radiography and radioisotope scintigraphy were effective methods in the diagnosis of postoperative gastroparesis.Eighteen cases(72%) in 4 week,and 22 case(88%) in 5 week after operation had achieved normal gastrointestinal movement by total parenteral nutrition(TPN) together with prokinetic drugs.Two patients(8%) recovered after 7 weeks were both performed reoperation.Conclusion Postoperative gastroparesis can recover spontaneously after a longer period of supportive treatment by TPN combined with prokinetic drugs,and second surgery should be avoided.
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