위 수술 후 급·만성 위장관 장애: 기질적 vs. 기능성

Abstract

The need for gastric surgery for peptic ulcer disease has decreased since the discovery of Helicobacter pylori and the development of proton pump inhibitors. Nevertheless, the total frequency of gastric surgery has increased due to the frequent detection of early gastric cancer and the increasing morbidity of pathological obesity. After gastric surgery, several unwanted gastrointestinal (GI) problems can develop as a result of the altered anatomy, volume reduction, or vagal impairment. Acute organic GI problems after gastric surgery include intraoperative or postoperative intestinal bleeding, leakage, and obstruction. Chronic organic problems include anastomosis site strictures, various metabolic disturbances, retained antrum syndrome, afferent or efferent loop syndrome, and gallstones. Chronic functional problems after gastric surgery include dumping syndrome, acid or bile regurgitation, postvagotomy diarrhea, and gastroparesis. Recently, concern about patients’ postoperative quality of life and life expectancy after gastric surgery has increased. To avoid undesirable outcomes after gastric surgery, the early detection and appropriate management of surgery-related disturbances are important. Therefore, it will be helpful to review these problems here. (Korean J Med 78:170-176, 2010) Key Words: Gastrectomy; Complications; Gastrointestinal diseases