Gastric dumping syndrome surgery
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Differentiating Gastric dumping syndrome from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Umar Ahmad, M.D.[2]
Overview
Surgery is not the first-line treatment option for patients with dumping syndrome. Surgery is usually reserved for patients as a last resort.
Indications
Surgical intervention is not recommended for the management of dumping syndrome. The indications for surgery are:[1]
- Treatment refractory dumping syndrome
- After all other options are exhausted
Surgery
The following are surgical procedures usable after the exhaustion of all other options of therapy:[2][3][4][5][6]
| Procedure | Mechanism | Complications |
|---|---|---|
| Stoma revision | Narrowing of the gastrojejunal stoma | Stomal strictures, Gastric outlet obstruction |
| Jejunal interposition | Creation of a long iso- or antiperistaltic limb between stomach and jejunum | Ulceration and stenosis of the interposed segment |
| Pyloric reconstruction | Modification of pyloroplasty by cutting the pyloroplasty incision and its longitudinal closure | Low-risk |
| Billroth I to Billroth II conversion | Restoration of physiologic delivery of the meal to the duodenum | Low-risk |
| Roux limb conversion to Roux-en-Y gastrojejunostomy | Slowing rate of gastric emptying and chyme transit via the Roux limb | Roux stasis |
| GI retrograde electrical pacing | Experimental procedure (No human studies have been performed) |
References
- ↑ Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R (2009). "Pathophysiology, diagnosis and management of postoperative dumping syndrome". Nat Rev Gastroenterol Hepatol. 6 (10): 583–90. doi:10.1038/nrgastro.2009.148. PMID 19724252.
- ↑ "www.practicalgastro.com" (PDF).
- ↑ Delcore, Romano; Cheung, Lawrence Y. (1991). "Surgical Options in Postgastrectomy Syndromes". Surgical Clinics of North America. 71 (1): 57–75. doi:10.1016/S0039-6109(16)45333-8. ISSN 0039-6109.
- ↑ Hinshaw, David B.; Stafford, Clarence E.; Joergenson, Eugene J. (1957). "Surgical treatment of the "dumping syndrome"". The American Journal of Surgery. 94 (2): 242–250. doi:10.1016/0002-9610(57)90651-7. ISSN 0002-9610.
- ↑ Nagel CB (1967). "Clinical experiences with jejunal interposition for postgastrectomy syndrome". Calif Med. 107 (5): 399–405. PMC 1502978. PMID 6083245.
- ↑ Jordan PH, Thornby J (1987). "Should it be parietal cell vagotomy or selective vagotomy-antrectomy for treatment of duodenal ulcer? A progress report". Ann. Surg. 205 (5): 572–90. PMC 1493033. PMID 3555364.