[Pathophysiology of gastric pouch surgery].

Reservoir function of a jejunum pouch is better than a simple Roux-en-Y limb. Postoperative processes of adaptation take at least 6 months. Pouch volume increases substantially after the operation and reaches about 200% of its initial volume. Morphological structure changes with muscular wall hypertrophy, plump deformation and widening of the villi, and a reduction of the mucosal surface. There is a change of motility pattern with a reduction of the propagation velocity. Randomized studies demonstrate a better reservoir function, less reflux, less heart burn, a slower passage time and fewer dumping symptoms after pouch reconstruction.