Vergleichende röntgenmorphologische Untersuchungen bei verschiedenen Formen der Ersatzmagenbildung: Roux-Y, Longmire-Guetgemann, Tübinger Ersatzmagen

Abstract

The indications for gastrectomy are increasing. More than 50 operations have been devised for reconstruction of the gastric function, but none is ideal. They should be judged particularly by their ability to form a reservoir which permits intermittent empyting of food into the small bowel. The risk of ischaemic changes or of chronic mucosal inflammation must be avoided. On the assumption that functional disturbances could be characterised by study of the morphology, we have carried out studies of three different types of gastric reconstruction (Longmire-Gütgemann, Roux-Y and Tübinger). The parameters we chose to measure were the maximum diameter of the interposed segment, the thickness of the mucosal folds and, as far as possible, th length of the segment. Most marked dilatation was found with the Tübinger procedure. Nevertheless, the increased occurrence of circular contractions following the Longmire-Gütgemann and Roux techniques may also result functionally in the formation of a reservoir. In none of the above techniques was there evidence of disturbances of blood-flow, as shown by mucosal swelling in the interposed segment.