Dumping Syndrome Correction

The dumping syndrome manifests as heart discomfort, palpitations, fatigue, sweating, dizziness, nausea, vomiting, and even collapse in a short period of time after eating (especially sweets), and symptoms such as bowel or diarrhea. It is generally believed that the pyloric sphincter is lost after gastric surgery, and the food is discharged into the upper jejunum too quickly, and is hypertonic without mixing and diluting the gastrointestinal fluid. A large amount of extracellular fluid is inhaled into the intestinal lumen, resulting in a circulating blood volume. Reduced, but also with the sudden expansion of the intestinal lumen, release of serotonin, increased intestinal peristalsis, and stimulate the celiac plexus. This disease should be distinguished from hypoglycemia syndrome that occurs 2 to 4 hours after eating. The treatment of dumping syndrome is, in principle, symptomatic treatment, eating less meals, avoiding sweet, overheated fluids, and lying flat for 10 to 20 minutes after a meal. Most patients' symptoms can be gradually controlled to heal. Very few serious patients, after more than one year of treatment without improvement, should be corrected by surgery. The principle of surgery was changed to the stomach and duodenal jejunum surgery for the original Biro I surgery, and the Biro I procedure for the original Biro II. For young and middle-aged patients, patients with high gastric acid should also undergo vagus nerve trunk resection. Treatment of disease: dumping syndrome Indication The original dumping syndrome occurred after the Biro I procedure. Dumping syndrome that occurs after gastrectomy. Surgical procedure 1. Incision: Incision in the upper abdomen. 2. Cut the triangular ligament of the left lateral lobe of the liver, expose the iliac crest and the lower end of the esophagus, find out the vagus nerve before and after the stem, and remove each nerve from 3 to 5 cm (see vagus nerve stem cutting). 3. Cut the duodenal lateral peritoneum, fully separate the duodenum, and separate the adhesion between the original stomach and the duodenal anastomosis. Under the control of two non-injured intestinal clamps, cut the original anastomosis and fully remove it. Scar tissue for intervening purposes. 4. The jejunum is selected approximately 50 cm below the duodenal suspensory ligament because the mesentery and vascular arch of the intestinal fistula are of sufficient length. If it is intended to be a retrograde peristalsis, the length of the intestine segment is 10 to 12.5 cm, and if it is followed by a peristaltic fistula, it is 12.5 to 15 cm. Note that the mesentery and vascular arch of the bowel segment are preserved. 5. Through the avascular area of the transverse mesenteric membrane, the upper jejunum segment is lifted up. Regardless of the use of reverse or sinus peristalsis, the mesangial should be kept out of tension, so as not to affect the blood supply of the intestine. The anastomosis technique can be sutured with a single layer of 1-0 silk suture. 6. This completes the change from Biro I to the stomach between the duodenum and the duodenum, that is, the jejunum between the stomach and the duodenum. According to the design, the jejunal input fistula and the small curved side anastomosis at the junction of the stomach are cut off between 1 and 2, and the jejunum output sputum is cut off between the 3 and 4 points at about 12-15 cm below the abdomen of the large curved side of the stomach. The duodenal stump of the original suture was removed, and the scar was removed and set to 5 points. The suture is closed at 1 point, that is, the small curved side jejunal stump. The proximal side of the output iliac crest is anastomosed to the duodenal stump, that is, at 3 and 5 points. Finally, the input near duodenal suspensory ligament end and the distal end of the output end anastomosis, that is, 2, 4 points. Complete the procedure. For the dumping syndrome after the Moynihan method of proximal to large bending, it can be changed to Biro I type jejunal surgery. Postoperative diet A reasonable diet can take more high-fiber and fresh vegetables and fruits, balanced nutrition, including essential nutrients such as protein, sugar, fat, vitamins, trace elements and dietary fiber, with a combination of vegetarian and vegetarian foods. The complementary role of nutrients in food.