Duodenogastric reflux quantification in peptic ulcer surgery: comparison between different surgical techniques

Surgery. 1993 Jan;113(1):43-7.

Abstract

Background: We quantified duodenogastric reflux with 6-hour continuous intravenous infusion of technetium 99m-labeled hepatoiminodiacetic acid (99mTc-HIDA) and subsequent quantification in gastric juice.

Methods: For this purpose, 50 patients were studied who had undergone surgery on the stomach with different surgical techniques: bilateral vagotomy plus Heineke-Mikulicz pyloroplasty, bilateral truncal vagotomy plus anterior pylorectomy, proximal gastric vagotomy, antrectomy and Billroth I reconstruction, and antrectomy and Billroth II reconstruction, comparing them with 10 healthy subjects used as a control group. We also studied the existing correlation between the rates of reflux determined by 99mTc-HIDA and those of total bile acids in gastric juice.

Results and conclusions: Patients who underwent gastric surgery had significantly greater quantities of duodenogastric reflux (p < 0.001) than had the control group. When the groups undergoing gastric surgery were compared, the patients who underwent resection showed higher reflux rates (p < 0.001) than did the patients who did not undergo resection. We found no differences among the groups of patients who did or did not undergo resection. We also found a highly significant correlation (p < 0.001) between the concentrations of 99mTc-HIDA and bile acids in gastric juice.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Bile Acids and Salts / analysis
  • Duodenogastric Reflux / complications
  • Duodenogastric Reflux / diagnostic imaging*
  • Gastrectomy / methods*
  • Gastric Juice / chemistry
  • Humans
  • Imino Acids* / analysis
  • Organotechnetium Compounds* / analysis
  • Peptic Ulcer / complications
  • Peptic Ulcer / surgery*
  • Postoperative Period
  • Radionuclide Imaging
  • Technetium Tc 99m Lidofenin
  • Vagotomy / methods*

Substances

  • Bile Acids and Salts
  • Imino Acids
  • Organotechnetium Compounds
  • Technetium Tc 99m Lidofenin