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 patients with dumping syndrome. Surgery is usually reserved for patients as a last resort. | [[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]] | ||
* After all options are exhausted | * After all other 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><ref name="DelcoreCheung1991">{{cite journal|last1=Delcore|first1=Romano|last2=Cheung|first2=Lawrence Y.|title=Surgical Options in Postgastrectomy Syndromes|journal=Surgical Clinics of North America|volume=71|issue=1|year=1991|pages=57–75|issn=00396109|doi=10.1016/S0039-6109(16)45333-8}}</ref><ref name="HinshawStafford1957">{{cite journal|last1=Hinshaw|first1=David B.|last2=Stafford|first2=Clarence E.|last3=Joergenson|first3=Eugene J.|title=Surgical treatment of the “dumping syndrome”|journal=The American Journal of Surgery|volume=94|issue=2|year=1957|pages=242–250|issn=00029610|doi=10.1016/0002-9610(57)90651-7}}</ref><ref name="pmid6083245">{{cite journal |vauthors=Nagel CB |title=Clinical experiences with jejunal interposition for postgastrectomy syndrome |journal=Calif Med |volume=107 |issue=5 |pages=399–405 |year=1967 |pmid=6083245 |pmc=1502978 |doi= |url=}}</ref><ref name="pmid3555364">{{cite journal |vauthors=Jordan PH, Thornby J |title=Should it be parietal cell vagotomy or selective vagotomy-antrectomy for treatment of duodenal ulcer? A progress report |journal=Ann. Surg. |volume=205 |issue=5 |pages=572–90 |year=1987 |pmid=3555364 |pmc=1493033 |doi= |url=}}</ref> | ||
{| 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 | ||
| Line 38: | Line 39: | ||
|Roux limb conversion to [[Roux-en-Y]] [[gastrojejunostomy]] | |Roux limb conversion to [[Roux-en-Y]] [[gastrojejunostomy]] | ||
|Slowing rate of [[Stomach|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 (medicine)|stasis]] | ||
|- | |- | ||
|[[Gastrointestinal tract|GI]] retrograde electrical pacing | |[[Gastrointestinal tract|GI]] retrograde electrical pacing | ||
| Line 45: | Line 46: | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 16:32, 15 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]; 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.