Gastric dumping syndrome surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Gastric dumping syndrome}} | {{Gastric dumping syndrome}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{UA}} | ||
==Overview== | ==Overview== | ||
[[Surgery]] is not the [[first-line treatment]] option for [[Patient|patients]] with | [[Surgery]] is not the [[first-line treatment]] option for [[Patient|patients]] with dumping syndrome. [[Surgery]] is usually reserved for [[Patient|patients]] as a last resort. | ||
==Indications== | ==Indications== | ||
Surgical intervention is not recommended for the management of | Surgical intervention is not recommended for the management of dumping syndrome. The indications for [[surgery]] are:<ref name="pmid19724252">{{cite journal |vauthors=Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R |title=Pathophysiology, diagnosis and management of postoperative dumping syndrome |journal=Nat Rev Gastroenterol Hepatol |volume=6 |issue=10 |pages=583–90 |year=2009 |pmid=19724252 |doi=10.1038/nrgastro.2009.148 |url=}}</ref> | ||
* Treatment [[refractory]] [[Gastric dumping syndrome|dumping syndrome]] | * Treatment [[refractory]] [[Gastric dumping syndrome|dumping syndrome]] | ||
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{| class="wikitable" style="margin: 1em auto 1em auto" | {| class="wikitable" style="margin: 1em auto 1em auto" | ||
|+ '''Surgical Procedures''' | |+ '''Surgical Procedures''' | ||
!Procedure | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Procedure | ||
!Mechanism | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mechanism | ||
!Complications | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Complications | ||
|- | |- | ||
|[[Stoma]] | |[[Stoma]] revision | ||
|Narrowing of the gastrojejunal [[stoma]] | |Narrowing of the gastrojejunal [[stoma]] | ||
|[[Stoma|Stomal]] strictures, [[Gastric outlet obstruction]] | |[[Stoma|Stomal]] strictures, [[Gastric outlet obstruction]] | ||
|- | |- | ||
|Jejunal | |Jejunal interposition | ||
|Creation of a long iso- or antiperistaltic limb between stomach and [[jejunum]] | |Creation of a long iso- or antiperistaltic limb between stomach and [[jejunum]] | ||
|Ulceration and [[stenosis]] of the interposed segment | |Ulceration and [[stenosis]] of the interposed segment | ||
|- | |- | ||
|Pyloric | |Pyloric reconstruction | ||
|Modification of [[pyloroplasty]] by cutting the [[pyloroplasty]] incision and its longitudinal closure | |Modification of [[pyloroplasty]] by cutting the [[pyloroplasty]] incision and its longitudinal closure | ||
|Low-risk | |Low-risk |
Latest revision as of 16:32, 15 December 2017
Gastric dumping syndrome Microchapters |
Differentiating Gastric dumping syndrome from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Gastric dumping syndrome surgery On the Web |
American Roentgen Ray Society Images of Gastric dumping syndrome surgery |
Risk calculators and risk factors for Gastric dumping syndrome surgery |
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.