Scoring system for evaluating functional disorders following laparoscopy-assisted distal gastrectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Medical Diagnostics

Background:

• No practical questionnaires exist for evaluating duodenogastric reflux post-gastrectomy.
• Laparoscopy-assisted distal gastrectomy (LADG) minimizes gastrointestinal adhesions.
• Duodenogastric reflux is a common complication after gastrectomy.

Purpose of the Study:

• To assess the utility of the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG) questionnaire in diagnosing duodenogastric reflux.
• To compare FSSG scores with endoscopic findings in patients after LADG.

Main Methods:

• 163 patients undergoing LADG (Billroth-I or Roux-en-Y) were included.
• Endoscopy was performed at least 6 months post-surgery.
• FSSG scores were collected and compared with endoscopic results.

Main Results:

• In Roux-en-Y, higher FSSG scores correlated with remnant gastritis and bile reflux.
• In Billroth-I, higher FSSG scores correlated with reflux esophagitis.
• FSSG demonstrated 71% sensitivity and 76% specificity for remnant gastritis in Roux-en-Y.

Conclusions:

• The FSSG questionnaire is a practical tool for assessing duodenogastric reflux in Roux-en-Y reconstruction post-LADG.
• FSSG is not recommended for Billroth-I reconstruction following LADG.
• This questionnaire offers a less invasive diagnostic alternative.