Analysis of esophageal reflux after proximal gastrectomy measured by wireless ambulatory 24-hr esophageal pH monitoring and TC-99m diisopropyliminodiacetic acid (DISIDA) scan.

Abstract

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.

DOI: 10.1002/jso.21560

Cite this paper

@article{Kim2010AnalysisOE, title={Analysis of esophageal reflux after proximal gastrectomy measured by wireless ambulatory 24-hr esophageal pH monitoring and TC-99m diisopropyliminodiacetic acid (DISIDA) scan.}, author={Jong Won Kim and Hongman Yoon and Seong-Ho Kong and Joo-Sung Kim and Jin Chul Paeng and Hyuk-Joon Lee and Kuhn Uk Lee and Han-Kwang Yang}, journal={Journal of surgical oncology}, year={2010}, volume={101 7}, pages={626-33} }