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Thai Nguyen Hung

National Cancer Hospital, Vietnam

Presentation Title:

Delayed gastric emptying post subtotal gastrectomy for gastric cancer

Abstract

Study aim: 1. Clinical and paraclinical features and risk factors of delayed gastric emptying post subtotal gastrectomy for gastric cancer. 2. Diagnosis, treatment of delayed gastric emptying. Patient and method: + Retrospective study. + Case report (rare diseases). 

Result: There were 4 patients; 2 males, 2 females, mean age: 65.5 Y (Range: 60-72 Y), the average onset time post gastrectomy 10,75 day (range 10-12 day); of them, 3 patients had diabetes, one had emotional stress and anxiety preoperation.
 
The lesion per operation: 1 had pyloric obstruction, 3 patient had tumors located at the body or lesser curvature of stomach. Operation performed: Subtotal gastrectomy with billroth 2 reconstruction (Finsterer) and lymph node D2 dissection.  Clinical manifestations post gastrectomy: nausea, bloating, vomiting. Plain Xrays: No hydro - air level, no intertinal obstruction. Barium serial Xrays (Telebrix): post 6h: retained telebrix in lumen of remnant anastomosis, the transit time more than 12h for emptying all telebrix, dilatation of remnant stomach, no mechanical obstruction (Telebrix went downward to colon). All patients had medical treatment consisting of nutrient support and erythromycin with half dosage orally. 3 of them had good recovery, one had acupuncture and electromechanics acupuncture. The average hospital stay (post onset delayed gastric emptying): 6.75 days (range 5-12 days). 

Conclusion: Delayed gastric emptying post subtotal  gastrectomy  appeared  on 10.75 days (average time). 

Risk factors included: Type 2 diabetes, pyloric obstruction, location of tumor in the lower body of stomach or lesser curvature. Diagnosis: Barium serial Xrays showed retained barium (telebrix) intra lumen of stomach remnant post 6 h with remnant anatomosis dilatation. Treatment consisted of: Nutrition support, naso tube aspiration, oral erythromycin (low dosage) in combination with electromechanics acupuncture

Biography

Thai Nguyen Hung graduated from Hanoi Medical University in 1993. He achieved his master’s degree in surgery in 2002 and his doctorate in surgery in 2009. In 2003 – 2004, he was a resident doctor in France. He has over 25 years of working experience in Vietnam – Germany hospital, Hanoi (a hospital with over 1000 beds for surgery) and 6 years of working experience in National Cancer Hospital (with over 2000 beds). His speciality is abdominal and digestive surgery. He has written over 50 articles.