The pathophysiology of afferent loop syndrome.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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In literature reports dealing with assessment of the long-term results after gastric resection a great diversity exists in terms of clinical definition, denominations, and classification of the late post-resection complications. This gave sufficient reason to the author to carry out personal researches into 126 patients with expressed late complications subsequent to gastric resection with a view to elucidate the type aad incidence of these complications, their etiopathogenesis, clinical peculiarities, possibilities of diagnosis and differential diagnosis and treatment problems, and on the basis of the results obtained to work out a personal classification scheme of post-resection complications which would be utilized both in connection with the diagnosing and treatment of these complications, and in assessment of the long-term results of gastric resection. In the suggested classification are included pathological syndromes representing true post-resection complications and never recorded without resection of the stomach; they run a prolonged course, and exert a permanent effect on the clinical condition and working ability of the operated patients, they are characterized by a typical symptom constellation on the basis of which it is possible to diagnose and differentiate them, and are conditioned by a variety of pathogenetic mechanisms demanding different treatment policy. The pathogenetic and clinical characteristic of the syndromes included in the classification (e.g. dumping syndrome, afferent loop syndrome, digestive insufficiency syndrome, hypoglycemic syndrome, and ulcerous recurrences after gastric resection)are briefly outlined.
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The article studies the possibilities of radionuclide method in disclosing the basic postgastroresectional syndromes: dumping syndrome, duodenogastric reflux and afferent loop syndrome. After resection of stomach 92 patients were examined throughout a period from 1 to 10 years. During dynamic scintigraphy of liver characteristic changes were disclosed in biliary secretory system which could have diagnostic significance. This method gives the possibility to determine the frequency, duration and volume of duodenogastric reflux. It was found out that Roux's [correction of Rue's] method of resection have resulted in minimal number of duodenogastric refluxes. Dynamic scintigraphy of stomach is useful for studying evacuative function of the resected stomach and for afferent loop syndrome diagnosis, which sometimes is more informative than a wide-spread barium sulfate roentgenological method.
The article deals with 33-year experience in surgical treatment of 200 patients. Among the indications for surgery were severe degrees of the dumping syndrome, the afferent loop syndrome, moderately severe progressive forms of these syndromes, and a stable pain syndrome and bilious vomiting in reflux gastritis. Three types of reconstructive operations were performed: gastroejunoduodenoplasty in 152 patients, gastroduodenoanastomosis in 20 patients, and formation of gastrojejunal Y-shaped EEA after Roux in 28 patients. The operations was complemented by vagotomy in 96 patients. One patient died after operation performed in the clinic. In the late-term periods after reconstructive gastroejunoplasty positive results were recorded in 91% of patients examined.