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Relationship between gastroesophageal reflux and gastric emptying after distal gastrectomy
Y Fujiwara1, K Nakagawa, T Tanaka
1Second Department of Surgery, Hyogo College of Medicine, Japan.
Objectives:
Our objective was to determine whether delayed gastric emptying contributes to gastroesophageal reflux after distal gastrectomy.
Methods:
To study gastric emptying and gastroesophageal reflux, we used a tecnnetium-labeled mixed liquid and solid test meal in 46 distal gastrectomy patients (19 with reflux symptoms and 27 without) and in 10 controls. The relationship of reflux symptoms to gastric emptying and the correlation between gastric emptying and the scintigraphic reflux index were evaluated.
Results:
The reflux index was significantly higher in the symptomatic group (9.76 +/- 5.64%) than in the asymptomatic group (4.45 +/- 2.70%). The gastric emptying half time was significantly longer in the symptomatic group (53.13 +/- 19.39 min) than in asymptomatic group (34.26 +/- 20.40 min) and in normal controls (27.31 +/- 4.60 min). There was a significant linear correlation between the scintigraphic reflux index and the gastric emptying half time (r = 0.505,p < 0.001).
Conclusions:
These findings suggest that scintigraphy is a reasonably accurate test for detecting gastroesophageal reflux and that delayed gastric emptying plays an important role in the development of reflux after distal gastrectomy.