Risk Factors for Food Residue after Distal Gastrectomy and a New Effective Preparation for Endoscopy: The Water-Intake Method

Abstract

Background/Aims: Food residue is frequently ob-served in the gastric remnant after distal gastrectomy, despite adequate preparation. We devised a water-in-take method to reduce food residue in the gastric remnant by drinking large quantities of water in a short time. The aims of this study were to identify the risk factors for food residue and to study the effec-tiveness of this new method for endoscopy prepa-ration. Methods: A cohort of 708 patients who under-went distal gastrectomy for gastric cancer was re-viewed prospectively. Sixty patients with large amo-unts of food residue were randomly divided into two groups: a water-intake group (n=40) and a prolonged fasting group (n=20). Results: The incidences of a large amount of food residue were 15.7%, 5.8%, 7.5%, and 2.8 % at 3, 12, 24, and 36 months, re-spectively, after distal gastrectomy. Independent risk factors for food residue were endoscopy at 3 months, diabetes mellitus, a body mass index of ＜19.5, and laparoscopic surgery. The proportion of successful preparations at follow-up endoscopy was higher for the water-intake group (70%) than for the prolonged fasting group (40%, p=0.025). Conclusions: The wa-ter-intake method can be recommended as a prepara-tion for endoscopy in patients who have had repetitive food residue or risk factors after distal gastrectomy