Truncal vagotomy, antrectomy and Roux-en-Y gastrojejunostomy in the treatment of duodenogastric reflux disease.

Abstract:

BACKGROUND/AIMS:The surgical treatment of duodenogastric reflux (DGR), resistant to medical therapy, in patients with intact stomach is difficult to standardize. The aim of this study is to present our experience on 5 patients, all cholecystectomized, with severe DGR disease treated surgically. METHODS:Out of a group of 223 patients suffering from nonulcerous dispeptic pathology presenting to our department, we selected 5 patients suffering from alkaline reflux gastritis in intact stomach. The diagnosis of primary DGR was made using Wilson's criteria. The surgical procedure adopted consisted of a truncal vagotomy, antrectomy, and a Roux-en-Y gastrojejunostomy. RESULTS:No perioperative mortality was observed. Twelve months after surgery all patients expressed satisfaction with the result of the operation and complained of no severe disturbances. A sense of postprandial fullness with a sense of pain in the left shoulder persisted in one case only, requiring the consumption of small and frequent meals. Radiological examination of the upper gastrointestinal tract of these patients showed notably delayed emptying of the gastric stump, while the endoscopic picture was completely normal. CONCLUSION:The antrectomy and Roux-en-Y gastrojejunostomy is a better known operation, easily executed, and has the advantage that it can be performed on patients previously operated on for gastric resection and therefore suffering from secondary reflux. It also has the advantage of removing the gastric antrum where mucous atrophy is more frequent and is susceptible to neoplastic degeneration. However, at the present time the choice between different types of operation depends exclusively on the personal conviction and experience of the surgeon.

journal_name

Dig Surg

journal_title

Digestive surgery

authors

Civello IM,Brisinda G,Palermo A,Agresti M,Minelli S,Sganga G,Maria G

doi

10.1159/000018583

subject

Has Abstract

pub_date

1998-01-01 00:00:00

pages

30-4

issue

1

eissn

0253-4886

issn

1421-9883

pii

dsu15030

journal_volume

15

pub_type

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