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


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.
Parrilla
P
P
Department of General Surgery, Virgen de la Arrixaca, University Hospital, University of Murcia, El Palmar, Spain.
Lujan
J A
JA
Robles
R
R
Torralba
J A
JA
Fuente
T
T
Cifuentes
J
J
Perez
D
D
D001647:Bile Acids and Salts / Q000032:analysis; D004383:Duodenogastric Reflux / Q000150:complications / Q000000981:diagnostic imaging*; D005743:Gastrectomy / Q000379:methods*; D005750:Gastric Juice / Q000737:chemistry; D006801:Humans; D007098:Imino Acids / Q000032:analysis; D015609:Organotechnetium Compounds / Q000032:analysis; D010437:Peptic Ulcer / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D011877:Radionuclide Imaging; D019780:Technetium Tc 99m Lidofenin; D014628:Vagotomy / Q000379:methods*
D001647:Bile Acids and Salts; D007098:Imino Acids; D015609:Organotechnetium Compounds; D019780:Technetium Tc 99m Lidofenin