[Combined use of iso and aniso-peristaltic jejunal loops to reestablish continuity after total gastrectomy (author's transl)].

Following experiments in animals, a new procedure for gastric replacement after total gastrectomy has been employed since 1972. Digestive tract continuity is reestablished by interposing two jejunal segments, on iso- and the other aniso-peristaltic, between the esophagus and the duodenum. The proximal isoperistaltic segment should be between 30 and 40 cm in length, while the distal anisoperistaltic segment should measure 10 cm. The latter segment replaces the pylorus and produces delayed intermittent emptying of the proximal iso-peristaltic segment. Their progressive dilatation results in the development of a new reservoir which reaches its maximum volume after 6 to 12 months. Radiological, cinematographic, and endoscopic examination in 58 patients in whom this reconstruction had been performed demonstrated that function was excellent. Results of metabolic studies and tests for clinical function confirmed the value of the method, which has definite advantages over previous techniques employed to reestablish continuity. For this reason, the method has become a routine procedure in patients requiring extensive total gastrectomies.