Current status of the treatment of common bile duct stones after Billroth Ⅱ subtotal gastrectomy / 临床肝胆病杂志

Common bile duct stones are a common of digestive system disease, and as one of the long-term complications after Billroth II subtotal gastrectomy, it has attracted more and more attention from clinicians. Common bile duct stones after Billroth II subtotal gastrectomy have a complex pathogenesis, including neurological, humoral, and mechanical factors. Even though there are many methods to remove stones, there are still controversies over the selection of digestive endoscopy, surgical operation, or percutaneous transhepatic approach. Clinicians should fully evaluate the specific conditions of patients and formulate individualized treatment regimens to achieve the best treatment outcome.

Clinical effect of Chinese and western medicine in the treatment of gastric emptying disorder after gastric cancer surgery / 中国基层医药

Objective To observe the curative effect of traditional Chinese and western medicine in the treatment of functional delayed gastric emptying after major gastrectomy.Methods From March 2010 to March 2015, a total of 128 cases with gastric dissection of functional delayed gastric emptying after major gastrectomy in the Affiliated Hospital of Chengdu University of TCM were divided into control group ( n＝64) and observation group ( n ＝64) based on a random number table.The control group was given western medicine,the observation group was given traditional Chinese medicine combined with Western medicine.The clinical efficacy,gastric function recovery time of the two groups were compared.Results The gastric function recovery time in the observation group was (14.12 ±1.36)d, which was significantly shorter than (20.56 ±2.10)d in the control group,and the difference was statistically significant (P＜0.05).The total effective rate of the observation group (87.50%) was significantly higher than that of the control group (68.75%),and the difference was statistically significant ( P＜0.05).Conclusion Comprehensive therapy combined with western and Chinese medicine in the treatment of functional delayed gastric emptying after major gastrectomy has significant clinical effect ,which is worthy of further application.

Progress of risk factors of gastroparesis syndrome after radical distal gastrectomy / 肿瘤研究与临床

Postsurgical gastroparesis syndrome (PGS), as a kind of very serious complication, usually followed radical distal gastrectomy due to gastric cancer. The occurrence of PGS affects the patients' postoperative recovery. The pathogenesis of PGS is still unknown throughly at present. According to the current researches,it is considered as a kind of functional delayed gastric emptying caused by a series factors. This paper reviews the progress of risk factors for PGS,with a view to providing clinical guidance.

Nursing Intervention for a Delayed Gastric Emptying after Pylorus-preserving Gastrectomy for Early Gastric Cancer

PURPOSE: The purpose of this case report is to describe the surgical procedure of pylorus preserving gastrectomy and treatment methods, and the nursing process for postoperative complications namely delayed gastric emptying. METHODS: This case study describes the treatment methods and nursing process for a patient who visited the emergency room because of delayed gastric emptying after a pylorus preserving gastrectomy. RESULTS: The symptoms of this patient were resolved by botox-injection, none per oral, total parenteral nutrition, nutrition education after diagnosis by using abdominal x-ray, gastric emptying study, upper gastrointestinal series, and esophagogastroduodenoscopy. CONCLUSION: According to the result of this case study, nurses should be informed about delayed gastric emptying and how to apply the correct nursing process to the patient.

Prevention and treatment of delayed gastric emptying after operation for esophageal carcinoma / 中国基层医药

Objective To investigate the cause,treatment and prevention of delayed gastric emptying (DGE) after operation for esophageal carcinoma.Methods The clinical data of 13 cases with DGE after operation for esophageal carcinoma were analyzed retrospectively.Results DGE occurred at 10th day after operation.10 cases with functional delayed gastric emptying(FDGE) recovered after conservative treatmeut.3 cases with mechanical delayed gastric emptying(MDGE) were given surgical treatment.Conclusions The anatomical displacement of stomach may be the main cause of DGE.DGE is also related to vagus nerve and postoperative inadequate gastrointestinal decompression.Clinical symptoms,X-ray barium meal radiography and gastroscopy examination are the important diagnostic method.Conservative treatment should be the first choice for FDGE.The use of some gastro-intestinal prokinetic drugs may have a beneficial effect on FDGE.Once the diagnosis of MDGE is established,surgical treatment should be performed as early as possible.The fully preoperative preparation,the precise and concise techniques in operation and postoperative appropriate management may decrease the occurrence of DGE.

Diagnosis and treatment of functional delayed gastric emptying after subtotal gastrectomy:a report of 15 cases / 中国基层医药

Objective To explore the etiology,pathogenesis,diagnosis and treatment of functional evacuation disorder in gastric stump after subtotal gastrectomy. Methods 15 cases with functional evacuation disorder after sub-total gastrectomy were analyzed retrospectively. Results All 15 cases were recovered by conservational therapy. Con-dusion Functional delayed gastric emptying after subtotal gastrectomy is a functional disease and can be healed with comprehensive conservation therapy at all.

Nutritional treatment after gastrectomy

Nutrition plays a major role in cancer development and treatment. Malnutrition is a significant and common problem in cancer patients and has been recognized as an important component of adverse outcomes, including increased morbidity and mortality. At the time of diagnosis, the majority of patients with upper gastrointestinal cancer, including those having undergone gastrectomy, have already suffered from significant nutritional deficiencies. Therefore, optimization of nutritional status can help cancer patients maintain the body's nutrition stores and improve symptoms such as anemia and neuropathy that may be associated with nutritional deficiencies. Depending on the etiology of symptoms, iron or Vitamin B12 (injection or oral) may be given. Early recognition and detection of risk for malnutrition may be performed using nutrition screening followed by comprehensive assessments. The most effective approach to malnutrition and nutritional deficiency is the prevention of its initiation through nutrition monitoring and intervention.

Resultados del tratamiento quirúrgico del cáncer gástrico: Análisis de 423 casos / Surgical treatment of gastric cancer: results in 423 cases

Background: Gastric cancer is the second cause of cancer death worldwide and the first cause in Chile. Management of this pathology is controversial. Aim: To report the results on morbidity, mortality, and long-term survival rates of surgical treatment of gastric cancer, and compare them with those reported in the literature. Material and Methods: Follow up of 423 patients (aged 16 to 88 years, 271 males) operated for a gastric adenocarcinoma between 1996 and 2002. Patients were staged with the 5th edition of TNM staging system, and the 2nd edition in English of the Japanese Classification of Gastric Cancer. Morbidity was assessed using the classification of the Memorial Kettering Cancer Center group. Kapplan-Meier method was used to assay survival, and Log rank Test to compare long-term survivals. Results: Resectability of the lesions was 70.4 percent, and 88 percent of them corresponded to a curative-intended surgery. Seventy percent of patients were in stage TNM IIIA or higher at the moment of surgery. Mortality in curative intended operated patients was 4.2 percent, and morbidity was 33.7 percent. Overall five years survival rate was 33 percent: In the group with curative intended surgery it was 52 percent. Two years survival rate in the non intended curative group was 3.4 percent. Conclusions: The reported incidence of complications in our series is similar to that reported in the literature. Five year survival rates, morbidity and mortality were comparable to those reported abroad

Duodenojejunostomia látero-lateral: uma alternativa cirúrgica para o tratamento do "dumping" pós gastrectomia / Side to side duodenojejunostomy: a surgical alternative for dumping after gastrectomy

Most patients with partiaI gastrectomy have no postoperative problems. Some of them, however, develop severe nutritional disturbance, particularly those with Bilroth II reconstruction, which can be treated clinically in the majority of the cases. Those with important mal absorptive problems require surgery. In this article we present a technical alternative for those patients who need reintervention over a BII operation. Our technique has the advantage of not touching the duodenum previously sutured.