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Continuous 99mTc-HIDA infusion as a method for measuring duodenogastric reflux
J A Luján Mompeán1, P Parrilla Paricio, R Robles Campos
1Department of General Surgery, Virgen de la Arrixaca Hospital, University of Murcia, Spain.
The British Journal of Surgery
|April 1, 1990
Summary
The continuous 99mTc-HIDA infusion test accurately measures duodenogastric reflux and biliary elimination. This method shows higher reflux rates in post-Billroth I surgery patients compared to healthy individuals.
Area of Science:
- Gastroenterology
- Nuclear Medicine
- Biliary Physiology
Background:
- Duodenogastric reflux (DGR) is a condition where bile and duodenal contents flow back into the stomach.
- Accurate measurement of DGR is crucial for diagnosing and managing related gastrointestinal disorders.
- Existing methods for assessing DGR have limitations in accuracy and objectivity.
Purpose of the Study:
- To evaluate the efficacy of a continuous 99mTc-HIDA (technetium-99m mebrofenin) infusion test for quantifying duodenogastric reflux.
- To assess the biliary elimination of 99mTc-HIDA when administered via constant intravenous infusion.
- To correlate 99mTc-HIDA reflux measurements with bile acid concentrations in gastric juice.
Main Methods:
- A continuous intravenous infusion of 99mTc-HIDA was administered to 30 patients.
- Group A (10 patients) with T-tubes studied biliary elimination of 99mTc-HIDA.
- Group B (10 normal subjects) and Group C (10 Billroth I gastrectomy patients) were assessed for duodenogastric reflux.
Main Results:
- Continuous 99mTc-HIDA infusion demonstrated increased elimination in bile for 80-100 minutes, followed by a plateau.
- Patients who underwent Billroth I gastrectomy exhibited significantly higher duodenogastric reflux rates compared to normal subjects.
- 99mTc-HIDA reflux assessment showed a strong correlation with bile acid concentrations in gastric juice (r=0.75 in Billroth I patients, r=0.85 in controls).
Conclusions:
- Continuous 99mTc-HIDA perfusion is a valuable tool for assessing duodenogastric reflux.
- The test provides an accurate and objective method for measuring DGR.
- The findings support the utility of this nuclear medicine technique in clinical gastroenterology.