Jejunal pouch length influences metabolism after total gastrectomy.

BACKGROUND/AIMS: To determine whether the length of the jejunal pouch used for reconstruction after total gastrectomy influences the postoperative metabolic and clinical outcome. METHODOLOGY: Twenty-one patients who underwent total gastrectomy with long jejunal pouch reconstruction (length 20 cm: n = 9) or short jejunal pouch reconstruction (length 15 cm: n = 12) were studied. The volume of a single meal, clinical symptoms, glucose metabolism, and other metabolic parameters were studied. RESULTS: Food intake, body weight, and dumping symptoms were similar in both groups, but the short pouch group had less reflux symptoms. Serum albumin and total cholesterol levels were higher in the short pouch group than in the long pouch group at 12 months postoperatively (p < 0.05). However, the short pouch group showed reduced glucose tolerance. CONCLUSION: These findings suggest that jejunal pouch length might have a role in postoperative physiological status.