Combinative Therapy of Functional Delayed Gastric Emptying after Radical Gastrectomy
Yang Yong Quan Zhiwei (Department of General Surgery, Xinhua Hospital, Shanghai Second Medical University, Shanghai 200092)
Objective:To explore the pathogenesis of functional delayed gastric emptying (FDGE) after radical gastrectomy and evaluate the effect of Traditional Chinese medicine (TCM) combined with Western medicine on FDGE. Methods: A retrospective study was performed including 312 cases undergone radical gastrectomy during 6 years period time. Results: 15 FDGE cases were found and the overall incidence rate is 4.81%. Among these cases, 288 patients underwent radical operation (D 2 ), in which 12 FDGE cases (4.17%) were found; 3 FDGE cases (12.5%) were done in 24 patients undergone radical surgery and cholecystectomy. The syndromes of FDGE mainly included generous gastric juice, gastric-tube-shut intolerance (2 cases, 13.3%), gastric retention after liquid-diet (4 cases, 26.7%), and gastric retention after congee-diet (9 cases, 60%). The overall 15 FDGE cases were cured through medical therapy and the course ranged 11～32 (21.33±4.75d). None re-operation was performed. Conclusion: One of the skill reasons causing FDGE might be the over-height of gastrojejunostomic anastomosis. Incoordination between remnant and output loop might be closely related to PDGE. Enteral nutrition by nosal-jejunal tube might improve patient's status and enhance patient's tolerance on prolonged course. Patients have great spontaneous cure chance and re-operation should be cautious.
【CateGory Index】： R735.2