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Analysis of esophageal reflux after proximal gastrectomy measured by wireless ambulatory 24‐hr esophageal pH monitoring and TC‐99m diisopropyliminodiacetic acid (DISIDA) scan
Author(s) -
Kim Jong Won,
Yoon Hongman,
Kong SeongHo,
Kim JooSung,
Paeng Jin Chul,
Lee HyukJoon,
Lee Kuhn Uk,
Yang HanKwang
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21560
Subject(s) - medicine , reflux , gastroenterology , sequela , curvatures of the stomach , ambulatory , reflux esophagitis , bile reflux , gastrectomy , esophagus , stomach , surgery , cancer , disease
Background and objectives Reflux is one of the most common sequela after proximal gastrectomy (PG). The aim of this study was to find a predicting factor related to the character of esophageal reflux after PG. Methods Wireless ambulatory 24‐hr pH monitoring (for acid reflux, AR) and diisopropyliminodiacetic acid hepatobiliary scan (for bile reflux, BR) were performed on 24 patients who had reflux symptoms after PG with esophagogastrostomy from July 2008 to March 2009. Endoscopic examination was done and the length of remnant stomach (LoRS) was measure by postoperative UGI series. Results Eleven patients (45.8%) had only BR, 7 (29.2%) had AR only, Two patients (8.3%) had both acid and BR, and 3 (12.5%) had neither. The LoRS along greater curvature was significantly shorter in patients with only BR (16.11 ± 2.87 cm) than in patients with only AR (23.69 ± 6.15 cm, P = 0.003). Severity of symptoms or esophagitis was not significantly correlated with the content of acid or BR. Conclusion Reflux symptom after PG is caused by either bile or acid rather than both. Character of reflux was related to the LoRS. J. Surg. Oncol. 2010; 101:626–633. © 2010 Wiley‐Liss, Inc.