[Metabolic and surgical aspects of total gastrectomy (author's transl)]

A follow-up examination was possible in 63 patients from a total of 323 with a total gastrectomy. All patients gained weight. The laboratory findings are in the normal range except for the low level of serum carotene and vitamin A. Carotene is greatly reduced by duodenal bypass or a short interposition of a small intestine loop. Radiological, endoscopic and histological findings correlate closely. Also, a reflux into the lower third of the esophagus causes clinical discomfort in 2/3 of all patients after esophagojejunostomy with end-to-side anastomosis. The interpretation of the negative points in conjunction with follow-up findings demonstrates the advantage of Longmire's interposition of a long small intestine loop for post-gastrectomy reconstruction.