[A new reconstructive procedure, interposition of a jejunal pouch after proximal gastrectomy]

In this chapter we mention the significance or advantage of the new reconstructive procedure, interposition of a jejunal pouch after proximal gastrectomy. Instead of oesophagogastrostomy which often brought many postoperative complications, various techniques of anastomosis such as conventional jejunal interposition or double tract method were contrived. Although these techniques could reduce the incidence of postoperative problems such as reflux oesophagitis, it is very difficult to examine or remedy beyond the oesophagojejunostomy site after surgery. On the other hand, interposition of a jejunal pouch showed us many advantages. The volume of reconstructed stomach was adequate and the patients could eat enough actually. In case of need, endoscopic fiber could enter the remnant stomach or duodenum very easily. This is the big advantage for the treatment of the upper GI and hepato-biliary pancreatic diseases endoscopically or radiologically after proximal gastrectomy. For these reasons, we usually use interposition of a jejunal pouch between the oesophagus and remnant stomach after proximal gastrectomy.