We present a case of afferent loop syndrome(ALS)occurring after pancreaticoduodenectomy(PD)in a patient who had previously undergone total gastrectomy(TG),and review the English-language literature concerning reconstr...We present a case of afferent loop syndrome(ALS)occurring after pancreaticoduodenectomy(PD)in a patient who had previously undergone total gastrectomy(TG),and review the English-language literature concerning reconstruction procedures following PD in patients who had undergone TG.The patient was a69-year-old man who had undergone TG reconstruction by a Roux-en-Y method at age 58 years.The patient underwent PD for pancreas head adenocarcinoma.A jejunal limb previously made at the prior TG was used for pancreaticojejunostomy and hepaticojejunostomy.Despite normal patency of the hepaticojejunostomy,he suffered from repeated postoperative cholangitis which was brought on by ALS due to shortness of the jejunal limb(15 cm in length).We therefore performed receliotomy in which the hepaticojejunostomy was disconnected and reconstructed using a new Y limb 40-cm in length constructed in a double Roux-en-Y fashion.The refractory cholangitis resolved immediately after the receliotomy and did not recur.Review of the literature revealed the lack of any current consensus for a standard procedure for reconstruction following PD in patients who had previously undergone TG.This issue warrants further attention,particularly given the expected future increase in the number of PDs in patients with a history of gastric cancer.展开更多
Not much data are available regarding the electrical activity in the stomachs and intestines of elderly gastrectomized patients The purpose of this study was to determine the feasibility of using a complex dynamic met...Not much data are available regarding the electrical activity in the stomachs and intestines of elderly gastrectomized patients The purpose of this study was to determine the feasibility of using a complex dynamic method to analyze the electrogastrograms （EGGs） of healthy young, healthy elderly, and gastrectomized elderly male individuals. The authors analyzed the EGGs by using the maximum Lyapunov exponent （MLE）, which is one of the indices of the chaotic characteristics of time series. Significant differences were observed between the MLEs estimated from the, EGGs of the young and elderly individuals for most of the temporal intervals. The authors＇ data indicate that the EGGs of elderly gastrectomized subjects might be distinguished from the EGGs of healthy elderly individuals on the basis of the MLE distribution.展开更多
文摘We present a case of afferent loop syndrome(ALS)occurring after pancreaticoduodenectomy(PD)in a patient who had previously undergone total gastrectomy(TG),and review the English-language literature concerning reconstruction procedures following PD in patients who had undergone TG.The patient was a69-year-old man who had undergone TG reconstruction by a Roux-en-Y method at age 58 years.The patient underwent PD for pancreas head adenocarcinoma.A jejunal limb previously made at the prior TG was used for pancreaticojejunostomy and hepaticojejunostomy.Despite normal patency of the hepaticojejunostomy,he suffered from repeated postoperative cholangitis which was brought on by ALS due to shortness of the jejunal limb(15 cm in length).We therefore performed receliotomy in which the hepaticojejunostomy was disconnected and reconstructed using a new Y limb 40-cm in length constructed in a double Roux-en-Y fashion.The refractory cholangitis resolved immediately after the receliotomy and did not recur.Review of the literature revealed the lack of any current consensus for a standard procedure for reconstruction following PD in patients who had previously undergone TG.This issue warrants further attention,particularly given the expected future increase in the number of PDs in patients with a history of gastric cancer.
文摘Not much data are available regarding the electrical activity in the stomachs and intestines of elderly gastrectomized patients The purpose of this study was to determine the feasibility of using a complex dynamic method to analyze the electrogastrograms （EGGs） of healthy young, healthy elderly, and gastrectomized elderly male individuals. The authors analyzed the EGGs by using the maximum Lyapunov exponent （MLE）, which is one of the indices of the chaotic characteristics of time series. Significant differences were observed between the MLEs estimated from the, EGGs of the young and elderly individuals for most of the temporal intervals. The authors＇ data indicate that the EGGs of elderly gastrectomized subjects might be distinguished from the EGGs of healthy elderly individuals on the basis of the MLE distribution.
