Quantitative evaluation of bile diversion surgery utilizing 99mTc HIDA scintigraphy.
This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by 99mTc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative 99mTc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The enterogastric reflux indices of 10 asymptomatic control patients after Billroth II gastrectomy ranged from 4% to 45%. 99mTc HIDA scintigraphy is useful in evaluating patients before and after bile diversion surgery, and demonstrates the quantitative decrease in enterogastric reflux after such surgery.
D000328:Adult; D000747:Anemia, Hypochromic / Q000000981:diagnostic imaging; D001655:Bile Reflux / Q000000981:diagnostic imaging*; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging*; D001835:Body Weight; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D007098:Imino Acids; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013667:Technetium; D019780:Technetium Tc 99m Lidofenin; D013997:Time Factors
D007098:Imino Acids; D019780:Technetium Tc 99m Lidofenin; D013667:Technetium