Does the length of the interposed segment in the Henley procedure influence duodenogastric reflux? An experimental study

This study assesses duodenogastric reflux (DGR) using 99mTechnetium-diisopropyl iminodiacetic acid in unoperated dogs and in dogs 28 days after a Billroth II gastrectomy and 28 days after the Henley procedure. Fourteen mongrel dogs were divided randomly into two groups of seven each, according to the length of the interposed jejunal segment used (Group A 10 cm; Group B, 20 cm). All dogs were subjected to a Billroth II gastrectomy, followed by the Henley procedure 30 days later. In Group A, DGR was significantly lower in the preoperative period (median, 0.0%; range, 0.0-0.02%) than after gastrectomy (median, 0.13%; range, 0.08-0.70%) and the Henley procedure (median, 0.12%; range, 0.06-0.22%), but did not differ significantly after gastrectomy and jejunal interposition. In Group B, DGR was significantly higher after gastrectomy (median, 0.15%; range, 0.10-0.64%) than in the preoperative period (median, 0.00%; range, 0.00-0.09%) or than after the Henley procedure (median, 0.00%; range, 0.00-0.7%). DGR did not differ significantly between the preoperative period and after Henley procedure. After jejunal interposition, DGR was significantly higher in Group A than in Group B. The Henley procedure is effective in preventing DGR when the interposed segment is 20 cm in length.