| [ Summary ] |
The reflux of duodenal contents has been considered to play a major role in gastric remnant carcinogenesis. Numerous experimental studies have shown that duodenogastric reflux induces tumors without carcinogenic agents in the stomach after gastroenterostomy or after gastrectomy with Billroth II anastomosis. Among the duodenal contents, bile acids have been shown to promoted carcinogenesis after administration of carci-nogenic agents in rats. However, whether bile juice or pancreatic juice plays a more critical role in the initia-tion process of carcinogenesis remains obscure. Furthermore, our studies revealed that not only duodenogastric reflux but also denervation of the gastric remnant and the degree of gastritis at gastrectomy influence gastric remnant carcinogenesis, especially the location and type of cancer. From these results, pylorus preserving gastrectomy, jejunal interposition, and Roux-en Y anastomosis are recommended to prevent duodenogastric reflux and gastric remnant cancer. |