Evaluation of Gastroesophageal Reflux Disease Following Various Reconstructive Procedures for a Distal Gastrectomy

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2003 Aug 12

PMID 12910420

Citations 2

Authors

Takeo Kawamura

Akihiro Yasui

Yoshihisa Shibata

Norihiro Yuasa

Yuji Nimura

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Some patients develop gastroesophageal reflux disease (GERD) after a distal gastrectomy. In these patients, the evaluation of GERD with 24-h pH monitoring could be difficult because they may have an insufficient amount of gastric acid.

Patients And Methods: To evaluate GERD following a distal gastrectomy, we retrospectively evaluated 38 patients postoperatively with an acid reflux test (ART), a barium study, endoscopy, and esophageal manometry. Three reconstructive procedures, Billroth I (B-I group: 14 patients), Billroth II (B-II group: 11 patients), and jejunal interposition (interposition group: 13 patients) were compared with respect to GERD and short- term operation results.

Results: Operation time and postoperative hospital stay were longest in the interposition group. Reflux symptoms were present in ten patients (26%). The ART, barium study and endoscopy demonstrated evidence of GERD in 22 (58%), 10 (26%) and 4 (11%) of the 38 patients, respectively. The frequency of a positive ART in the interposition group was significantly lower than in both the B-I and the B-II groups. The abdominal length of the lower esophageal sphincter in the interposition group was higher than that in the B-II group ( P<0.05).

Conclusion: Although jejunal interposition required longer operation time and hospital stay, the lower esophageal sphincter function following jejunal interposition appears to be superior to that following a Billroth-I or Billroth-II procedure.

Citing Articles

Reflux esophagitis and marginal ulcer after pancreaticoduodenectomy.

Wu J, Tsai M, Hu R, Chang K, Lee P, Tien Y J Gastrointest Surg. 2011; 15(5):824-8.

PMID: 21347872 DOI: 10.1007/s11605-011-1463-4.

Prospective randomized trial comparing Billroth I and Roux-en-Y procedures after distal gastrectomy for gastric carcinoma.

Ishikawa M, Kitayama J, Kaizaki S, Nakayama H, Ishigami H, Fujii S World J Surg. 2005; 29(11):1415-20.

PMID: 16240061 DOI: 10.1007/s00268-005-7830-0.

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