Faecal fat and body weight changes following Roux-en-Y and jejunal loop interposition reconstructive technique in total gastrectomized dogs

ABSTRACT

Total gastrectomy is one of the most common operative procedures for gastric malignancy, but the recommended method of gastrointestinal reconstruction after gastrectomy is still controversial. Significant weight loss has been noted by many observers following gastrectomy. The Roux-en-Y method is the most frequent reconstructive technique performed after gastrectomy. This technique is easy to perform and prevents reflux esophagitis, but the major disadvantage of the technique is bypassing of the duodenum from the transit of food. This study was performed to compare two reconstructive techniques [the standard Roux-en-Y and jejunal loop interposition] after gastrectomy, considering post operative body weight loss in 10 healthy dogs. In group A, Roux-en-Y, following gastrectomy end to side anastomosis was performed between the distal jejunal end and remained part of the stomach. In group B, jejunal loop interposition, a 20 cm section of jejunal loop was resected and interposition of the loop was performed between the remaining part of the stomach and the duodenum. The patients were weighed before and after surgery until 30 days postoperatively and their weights were recorded daily. Also, faecal fat was measured on day 28 postoperatively. No fat was detected in faecal samples in group B, however different amounts of fat were measured in group A. Mean of preoperative weight was 28 +/- 3 kg. Data indicates a significant difference in mean of body weights in both groups pre and post operatively [P<0.05]. Mean percentage of body weights was significantly lower 67.18% +/- 4.4 in group A compared to group B [73.05% +/- 3.9] [P=0.04], which can indicate the importance of duodenal passage in reduction of post operative body weight loss