Interposition of the first jejunal loop for reconstruction after total gastrectomy

A new technique of reconstruction after total gastrectomy by interposing the first jejunal loop between the esophagus and the duodenum, is described. Vascular and neural integrity of the interposed intestinal segment is "guaranteed", resulting in acceptable muscular activity on intestinal contents and partial digestive function, with limited post-operative complications. The interposed jejunal loop assumes reservoir function and permits almost normal eating habits. Application of this technique to 18 patients undergoing total gastrectomy has resulted in a more than satisfactory post-operative functional and nutritional status over a one to 14 year follow-up period.