全胃切除后双腔空肠代胃术23例报告

目的探讨双腔空肠代胃术的临床使用效果。方法回顾性分析2000年至2009年23例双腔空肠代胃术的临床资料，胃小弯癌肿上侧近贲门，下侧累及幽门窦部15例，胃小弯癌肿累及贲门而下侧近幽门6例，弥漫性皮革胃2例。其中高、中分化腺癌各8例，低分化腺癌3例，未分化癌1例，黏液腺癌2例，印戒细胞癌1例。双腔空肠间置代胃吻合术8例，双腔空肠代胃Roux—Y吻合术15例。结果全组病例于术后2周均恢复顺利，术后1个月均可进食普食，6个月后达到正常饭量（单餐100g），体重恢复并维持术前水平16例，较术前减轻0．5～1．0kg7例。血红蛋白均维持在10g/L、血清白蛋白在35g/L左右。均经1年以上的随访，无肿瘤复发，双腔空肠问置代胃吻合术与双腔空肠代胃Roux—Y吻合术治疗效果无明显区别。结论双腔空肠代胃术是一种操作简便、效果良好的手术方式。

Double-cavity jejunoplasty for total gastrectomy: A report of 23 cases

Objective To explore the clinical affect of double - cavity jejunoplasty for total gastrectomy. Methods The clinical data of 23 patients who underwent double - cavity Jejunoplasty for total gastrectomy from January 2000 to December 2009 were retrospectively analyzed. There were body of stomach in lesser curvature involving gastric antrum and pylorus in 15 cases, body of stomach in lesser curvature involving the cardiac in 6 cases and diffuse infiltration of stomach（ sclerotic stomach） in 2 cases. High and middle differentiated adenocarcinoma occurred in 8 cases,low differentiated adenocarcinoma in 3 ca- ses, undifferentiated adenocarcinoma in 1 case, mucinous adenocarcinoma in 2 cases and signet ring cell carcinoma in 1 case. Double - cavity jejunoplasty for total gastrectomy in interposed anastomosis was per- formed in 8 cases and Roux - Y anastomosis in 15 cases. Results All patients were recovered two weeks after operation and resumed a normal diet （2oz/meal） 6 months postoperatively. Body weight returned to pre - operation level in 16 cases and was reduced by 0.5 to 1.0 kg in 7 cases. Hemoglobin maintained at 10g/L and serum albumin at 35g/L and more in all cases. All cases were followed up for 1 year and more without reoccurrence found. There was no difference in therapeutic affect between the B - Ⅰ and B -Ⅱ anastomosis. Conclusion Double - cavity jejunoplasty for total gastrectomy is a simple and easy manipula- tion with good clinical efficacy achieved.