[Evaluation of ileocolon interposition after total gastrectomy].

The most serious complaints after total gastrectomy are alkaline esophagitis and postalimentary syndrome. We have performed ileocolon interposition as a gastric substitution which uses the ileocecal valve to prevent bile reflux. The ileocolon segment consists of 7 cm of terminal ileum and 10 cm of coecum and ascending colon on a vascular pedicle. This isolated segment is rotated upwards between the esophagus and the duodenum. To evaluate the function of the ileocolon as a gastric substitute, Barium X rays, O-GTT and gastric emptying time (99Tc EDTA) were examined. Barium X-rays showed that the air at the coecal portion looks like a gastric fornix and there is no barium reflux into the esophagus even in the supine position. Likewise, there were no complaints from patients of symptoms of reflux esophagitis. In case of Rouxen-Y reconstructions, blood sugar level after O-GTT show oxyhyperglycemia. Those in ileocolon interposition rose rapidly, but almost to the same degree as in normal subjects. The appearance of the gastric emptying curve using Tc-DTPA in case of ileocolon interposition shows that there is good reservoir function.