Gastric dumping syndrome surgery: Difference between revisions
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==Indications== | ==Indications== | ||
Surgical intervention is not recommended for the management of dumping syndrome. | Surgical intervention is not recommended for the management of [[Gastric dumping syndrome|dumping syndrome]]. | ||
* Treatment refractory dumping syndrome | * Treatment [[refractory]] [[Gastric dumping syndrome|dumping syndrome]] | ||
* After all options are exhausted. | * After all options are exhausted. | ||
==Surgery== | ==Surgery== | ||
The following are surgical procedures usable after the exhaustion of all other options of therapy:<ref name="urlwww.practicalgastro.com">{{cite web |url=https://www.practicalgastro.com/pdf/February06/UklejaArticle.pdf |title=www.practicalgastro.com |format= |work= |accessdate=}}</ref> | The following are surgical procedures usable after the exhaustion of all other options of [[therapy]]:<ref name="urlwww.practicalgastro.com">{{cite web |url=https://www.practicalgastro.com/pdf/February06/UklejaArticle.pdf |title=www.practicalgastro.com |format= |work= |accessdate=}}</ref> | ||
{| class="wikitable" style="margin: 1em auto 1em auto" | {| class="wikitable" style="margin: 1em auto 1em auto" | ||
|+ '''Surgical Procedures''' | |+ '''Surgical Procedures''' | ||
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|Roux limb conversion to [[Roux-en-Y]] [[gastrojejunostomy]] | |Roux limb conversion to [[Roux-en-Y]] [[gastrojejunostomy]] | ||
|Slowing rate of gastric emptying and [[chyme]] transit via the Roux limb | |Slowing rate of [[Stomach|gastric]] emptying and [[chyme]] transit via the Roux limb | ||
|Roux stasis | |Roux stasis | ||
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Standardized liquid meal administration via a gastric tube demonstrated complete reversal of severe metabolic abnormalities including hypersecretion of insulin and incretin hormones such as GLP-1 compared with oral administration [127]. The authors of this publication also restored glucose homeostasis via the placement of a gastric tube in the remnant stomach of a patient who had undergone gastric bypass surgery (Dr. van Beek, unpublished observation). However, as these findings are based on individual case reports, clinical evidence supporting the use of continuous enteral feeding in the management of dumping syndrome is very limited. | |||
==References== | ==References== | ||
Revision as of 19:26, 12 December 2017
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Gastric dumping syndrome Microchapters |
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Differentiating Gastric dumping syndrome from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Gastric dumping syndrome surgery On the Web |
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American Roentgen Ray Society Images of Gastric dumping syndrome surgery |
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Risk calculators and risk factors for Gastric dumping syndrome surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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.
- Treatment refractory dumping syndrome
- After all options are exhausted.
Surgery
The following are surgical procedures usable after the exhaustion of all other options of therapy:[1]
| 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) |
Standardized liquid meal administration via a gastric tube demonstrated complete reversal of severe metabolic abnormalities including hypersecretion of insulin and incretin hormones such as GLP-1 compared with oral administration [127]. The authors of this publication also restored glucose homeostasis via the placement of a gastric tube in the remnant stomach of a patient who had undergone gastric bypass surgery (Dr. van Beek, unpublished observation). However, as these findings are based on individual case reports, clinical evidence supporting the use of continuous enteral feeding in the management of dumping syndrome is very limited.
References
References
- ↑ "www.practicalgastro.com" (PDF).