Pathologic duodenogastric reflux associated with persistence of symptoms after cholecystectomy.
Surgery
; 117(4): 421-8, 1995 Apr.
Article
em En
| MEDLINE
| ID: mdl-7716724
ABSTRACT
BACKGROUND:
The aim of this study was to determine whether increased duodenogastric reflux contributes to postcholecystectomy symptoms.METHODS:
Gastric pH monitoring, hepatobiliary scintigraphy, gastric emptying scans, and gastric acid analysis were performed in asymptomatic (n = 10) and in symptomatic (n = 27) patients after cholecystectomy. Normal subjects (n = 20), patients with dyspepsia related to gastric acid hypersecretion (n = 20), patients with reflux gastritis after gastric surgery (n = 10), and patients with confirmed primary pathologic duodenogastric reflux (n = 10) were studied as controls. Symptomatic patients also underwent upper gastrointestinal endoscopy.RESULTS:
Symptomatic patients had significantly increased interprandial gastric exposure to pH < 3 compared with asymptomatic subjects, which correlated well with a high incidence of hepatobiliary scans positive for abnormal duodenogastric reflux and chronic gastritis on endoscopy. Gastric alkaline exposure in symptomatic patients was similar to that seen in patients with primary pathologic duodenogastric reflux and patients with duodenogastric reflux related to gastric surgery. Gastric acid secretion and gastric emptying were not altered. Five patients tested before and after laparoscopic cholecystectomy showed that nocturnal gastric alkalization was enhanced after operation.CONCLUSIONS:
This study suggests that excessive duodenogastric reflux may be responsible for persistence of symptoms after cholecystectomy.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Colecistectomia
/
Refluxo Duodenogástrico
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Surgery
Ano de publicação:
1995
Tipo de documento:
Article
País de afiliação:
Estados Unidos