An experimental study of jejunal pouch replacements following total gastrectomy

The nutritional effects of pouch replacement after total gastrectomy remain clinically controversial. Two previous experiments failed to show any nutritional benefit. However, the pouches applied clinically and examined experimentally so far were all of anti-peristaltic type.

Male 7- or 8-week-old Wistar rats were divided into 3 experimental groups after total gastrectomy. For group 1 and 2 rats, Roux-en-Y reconstructions and Hunt-Lawrence pouches, i.e., anti-peristaltic type, were performed, respectively. Group 3 rats underwent a new type of iso-peristaltic pouch replacement. Food intake was recorded daily and all rats were weighed once a week. At the end of the 12-week experimental period, there were 9 rats in group 1, 10 in group 2, and 8 in group 3. The volumes of the gastric reservoirs were measured, and blood samples were taken. Five 20-week-old rats served as control of weight, food intake, and laboratory data.

The volumes of the gastric reservoirs in group 2 and 3 rats were significantly larger than in group 1 animals. However, there were no intergroup differences in weight change or food intake. The weights and the food intakes of the 3 experimental groups were significantly lower than those of the control rats. No superiority in the results of blood samples was observed among the experimental groups. Correlations between weight gain and food intake were shown in all groups. But, a correlation between the volume of the gastric reservoir and food intake was observed only for group 3 rats.

The present study showed no nutritional benefits of an iso- as well as an anti-peristaltic pouch replacement.