The indiations for total gastrectomy and methods for alimentary reconstruction after this operation have changed since Schlatter performed the first successful one in 1897. But, high mortality and complication rate after total gastrectomy is still a challenging problem. This paper presents our experiences of total gastrectomy based on 144 cases treated at the Seoul National University between May 1, 1975 to April 30, 1981. 1. Total gastrectomy was performed in 144 patients among 725 resectabe cases(20%). 2. Extended total gastrectomy was earried out in 79 patients, total gastrectomy without resection of the distal pancreas in 65 patients. 3. Seven patients expired due to postoperativs complications : One due to pancreatic fistula and the rest due to anastomotic leakage. The overall mortality rate was 4.8%, 4. Eighty postoperative complications developed in 49 patients: 13 wound infections, 11 pulmonary atelectasis, 9 anastomotic leakage etc. 5. Postoperative reflux esophagitis developed in 24 patients among 96 follow up check patients(25%). It was 27% in patients with end-to-side esophagojejunostomy and Braun anastomosis, 18% with Roux-en-Y esophagojejunostomy. The result was not statistically significant.
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