Objective To describe a new technique for digestive tract reconst ruction of total gast rectomy.Methods The modified functional jejunal interposition ( FJ I) was performed in 38 patient s who underwent total gastrectomy between June 2004 and March 2006. At digestive tract reconst ruction, the jejunum with suitable suture ligated at 2 cm distal to side-to-end jejunoduodenostomy was changed to sew up 2－3 needles and to narrow it . End-to-side esophagojejunostomy to Treitz ligament was shortened to 20－25 cm befittingly. Side2to2side jejunojejunostomy to Treitz ligament was 10 cm. Both esophagojejunostomy and jejunojejunostomy must not be tensioned. Results No patients died or had anastomotic leakage in perioperative period. Roux-en-Y stasis syndrome (RSS) was in 2 patients. The Visick grade: 35 patient s were grade Ⅰ, 3 patient s were grade Ⅱ. Serum nut ritional parameters in 2 patients hemoglobin was only lower than normal. At 6 months after operation , food intake per meal and body weight were recovered to the preoperative level in 36 patients, and only 2 patients appeared weight worse. One patient had reflux esophagitis and no dumping syndrome occurred. Through the upper gast rointestinal radiograph , the bariums entered into duodenal channels mostly , and a little into the narrow channels. Conclusion The modified FJ I not only reserved all advantages of the primary procedure , but also could further lower the complications and improve of the quantity life of the patients who were underwent total gast rectomy. It would be necessary for further prospective randomized controlled trial in tlhe largescale cases.
世界首例成功的全胃切除及消化道重建術（結腸前食管空腸端側吻合術）1897年由德國人Schlatter完成； 隨后Briigham對重建的術式做出了最早的探索，這一食管十二指腸吻合術也是最早的保留十二指腸食物通道功能的術式（Billroth Ⅰ）； 1903年Moynihan提出應加行空腸輸入-輸出袢之間的側側吻合（Braun吻合）； 1947年Orr提出的Roux-en-Y術式是最經典的不保留十二指腸食物通道功能的術式，以它為基礎的術式（Billroth Ⅱ）在全胃切除術后的消化道重建中占有主要地位［1］。......