Gastric dumping syndrome surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Umar Ahmad, M.D.[2]

Overview

Surgery is not the first-line treatment option for patients with dumping syndrome. Surgery is usually reserved for patients as a last resort.

Surgical intervention is not recommended for the management of dumping syndrome. The indications for surgery are:^[1]

The following are surgical procedures usable after the exhaustion of all other options of therapy:^[2]^[3]^[4]^[5]^[6]

**Surgical Procedures**
Procedure	Mechanism	Complications
Stoma revision	Narrowing of the gastrojejunal stoma	Stomal strictures, Gastric outlet obstruction
Jejunal interposition	Creation of a long iso- or antiperistaltic limb between stomach and jejunum	Ulceration and stenosis of the interposed segment
Pyloric reconstruction	Modification of pyloroplasty by cutting the pyloroplasty incision and its longitudinal closure	Low-risk
Billroth I to Billroth II conversion	Restoration of physiologic delivery of the meal to the duodenum	Low-risk
Roux limb conversion to Roux-en-Y gastrojejunostomy	Slowing rate of gastric emptying and chyme transit via the Roux limb	Roux stasis
GI retrograde electrical pacing	Experimental procedure (No human studies have been performed)

↑ Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R (2009). “Pathophysiology, diagnosis and management of postoperative dumping syndrome”. Nat Rev Gastroenterol Hepatol. 6 (10): 583–90. doi:10.1038/nrgastro.2009.148. PMID 19724252.
↑ “www.practicalgastro.com” (PDF).
↑ Delcore, Romano; Cheung, Lawrence Y. (1991). “Surgical Options in Postgastrectomy Syndromes”. Surgical Clinics of North America. 71 (1): 57–75. doi:10.1016/S0039-6109(16)45333-8. ISSN 0039-6109.
↑ Hinshaw, David B.; Stafford, Clarence E.; Joergenson, Eugene J. (1957). “Surgical treatment of the “dumping syndrome““. The American Journal of Surgery. 94 (2): 242–250. doi:10.1016/0002-9610(57)90651-7. ISSN 0002-9610.
↑ Nagel CB (1967). “Clinical experiences with jejunal interposition for postgastrectomy syndrome”. Calif Med. 107 (5): 399–405. PMC 1502978. PMID 6083245.
↑ Jordan PH, Thornby J (1987). “Should it be parietal cell vagotomy or selective vagotomy-antrectomy for treatment of duodenal ulcer? A progress report”. Ann. Surg. 205 (5): 572–90. PMC 1493033. PMID 3555364.