【摘要】 的　探讨全胃切除消化道重建的理想术式。方法　全胃切除术后利用带蒂的回盲部回肠制成“P”字代胃 ,自体的回盲瓣代替幽门 ,间置于食管和十二指肠间 ,形成“新胃”。结果　 2 0例病人术后 6个月均恢复一日三餐 ,平均每日进食量 5 80 g( 45 0～ 6 2 0 g) ,体重恢复或超过术前 16例 ,占 88.9% ( 16 / 18) ;代胃容积平均 385ml( 30 0～ 45 0m1) ,代胃排空时间平均 145分钟 ( 12 4～ 186m1)。全组无胸骨后疼痛 ,无食物、消化液返流等现象 ,无倾倒综合征 ,无脂肪性腹泻。 1、3年生存率为 :87.5 % ( 14/ 16 )和 6 0 % ( 6 / 10 )。结论　间置回盲部回肠“P”字代胃术是全胃切除消化道重建的理想术式 ,值得推广应用。更多还原

【Abstract】 Objective To investigate an ideal digestive tract reconstruction after total gastrectomy. Methods The "new stomach"was reconstructing by ileocecum and ileum with pedicle liking the word "p", pylorus were replaced by ileocecum valve. Results Three diets per day were restored in 6 months later after operation. The average amount of diet per day was 580g(450～620g). Sixteen patients restored or exceeded the weight as before operation. Average volume of "new stomach" was 385ml (300～450ml). Average empty time was 145 minutes (120～186 minutes). No poststernal pain and reflux existed. No dumping syndrome and fat diarrhea occurred. Survival rate for 1,3 year were 87.5% and 60%, respectively. Conclusion "p" shaped gastroreplacement with ileocecum and ileum is an ideal operative approach for digestive tract reconstruction after total gastrectomy, it can be used wildly.更多还原