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Alkaline reflux gastritis

F L Bushkin, E R Woodward

    Major Problems in Clinical Surgery
    |January 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Roux-en-Y diversion effectively treats duodenogastric reflux after gastric surgery, unlike previous methods. This surgical technique offers excellent relief from symptoms like bile vomiting and improves gastric emptying and nutrition.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Digestive System Surgery

    Background:

    • Pyloric sphincter ablation during gastric surgery increases duodenogastric reflux.
    • Reflux is common after Billroth II, Billroth I, and pyloroplasty procedures.
    • Bile acids and other duodenal constituents contribute to gastric mucosal damage.

    Purpose of the Study:

    • To evaluate the efficacy of Roux-en-Y duodenal diversion for treating severe duodenogastric reflux.
    • To compare Roux-en-Y diversion with previous treatments like interposed jejunal segments.
    • To assess the potential of Roux-en-Y reconstruction as a primary surgical approach.

    Main Methods:

    • Retrospective analysis of patients undergoing Roux-en-Y duodenal diversion for refractory duodenogastric reflux.

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  • Comparison of outcomes with historical data from patients treated with interposed jejunal segments.
  • Endoscopic and histopathologic evaluation of gastric mucosa before and after surgery.

    • Main Results:

    • Roux-en-Y diversion provided excellent relief in 24 of 25 patients, improving gastric emptying and nutrition.
    • Interposed jejunal segments showed disappointing results, with only 40% experiencing lasting relief.
    • Endoscopic and histologic improvements were observed in 23 of 25 patients post-Roux-en-Y surgery.

    Conclusions:

    • Roux-en-Y duodenal diversion is a highly effective treatment for severe alkaline reflux gastritis.
    • Primary use of Roux-en-Y reconstruction may prevent both afferent loop syndrome and alkaline reflux gastritis.
    • This approach warrants consideration for primary surgical reconstruction in specific peptic ulcer surgeries.