Near-Total Completion Gastrectomy for Severe Postvagotomy Gastric Stasis: Analysis of Early and Long-Term Results in 62 Patients

Adrienne W. Forstner-Bartbell, Michel M. Murr, Sami Nitecki, Michael Camilleri, Charlene M. Prather, Keith A. Kelly, Michael G. Sarr

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

The aim of this study was to evaluate results of completion gastrectomy for severe postgastrectomy gastric stasis. A total of 51 women and 11 men underwent completion gastrectomy for gastric stasis between 1985 and 1996; follow-up was complete in 98% at 5.4 ± 5 years. All patients had modified Visick scores preoperatively of grade III (37%) or IV (63%). Presentation included combinations of nausea, vomiting, postprandial pain, chronic abdominal pain, and chronic narcotic use. All had undergone prior vagotomy and had a median of four previous gastric operations. Hospital mortality was zero. Complications occurred in 25 patients (40%) and included the following: narcotic withdrawal syndrome (18%), ileus (10%), wound infection (5%), intestinal obstruction (2%), and anastomotic leak (5%). All or most symptoms were relieved in 43% (Visick grade I or II), but 57% of the patients remained in Visick grade III or IV. Nausea, vomiting, and postprandial pain were reduced from 93% to 50%, 79% to 30%, and 58% to 30%, respectively (P <0.05), but chronic pain, diarrhea, and dumping syndrome were not significantly affected. Univariate analysis revealed no preoperative characteristic to be predictive of good outcome. Logistic regression analysis suggested that the combination of nausea, need for total parenteral nutrition, and retained food in the stomach predicted a poor outcome (P <0.05). Completion gastrectomy is successful in 43% of patients. The combination of nausea, need for total parenteral nutrition, and retained food at endoscopy are negative prognostic factors.

Original languageEnglish (US)
Pages (from-to)15-23
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume3
Issue number1
StatePublished - Jan 1 1999

Keywords

  • Gastric emptying
  • Gastric stasis
  • Gastroparesis
  • Roux stasis syndrome

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Forstner-Bartbell, A. W., Murr, M. M., Nitecki, S., Camilleri, M., Prather, C. M., Kelly, K. A., & Sarr, M. G. (1999). Near-Total Completion Gastrectomy for Severe Postvagotomy Gastric Stasis: Analysis of Early and Long-Term Results in 62 Patients. Journal of Gastrointestinal Surgery, 3(1), 15-23.