[Early complications and long-term results after total gastrectomy. A contribution to finding a method of gastric replacement, based on own observations (author's transl)].

In the years 1963 up to 1973 in the Department of Surgery of the University of Düsseldorf a total gastrectomy was performed in 53 patients. For reconstitution of gastrointestinal continuity in 22 cases we interposed a single jejunal loop between the esophagus and duodenum, in 15 patients we performed an esophagojejunostomy with a long enteroanastomosis between the afferent and efferent loop. The procedure described by Tomoda was done in 11 patients. An esophagojejunostomy Roux-en-Y we used in 3 and an esophagoduodenostomy in only 2 cases. The hospital mortality was 21%, the cause of which were predominantly complications of the lung. A dehiscence of an anastomosis never was a cause of death. A follow-up we could perform in 15 patients. On the basis of clinical, roentgenological and chemical data received in the follow-up we prefer at this time the interposition of a single jejunal loop, the length of which should be no less than 40 cm.