title: Duodenogastric reflux after choledochoduodenostomy: evaluation by technetium-99m scintigraphy.
abstract: OBJECTIVE
  Persistence of dyspeptic symptoms after choledochoduodenostomy (CDD) is common. There is evidence that at least some of these symptoms may be attributed to duodenogastric reflux (DGR). The aim of the study was to quantify DGR after CDD.
  
  
  METHODS
  A total of 6 patients who had undergone cholecystectomy with a standard side-to-end CDD for choledocholithiasis or Lemmel syndrome were studied by symptom evaluation, biliary scintigraphy and endoscopy at least 6 months after surgery. Duodenogastric reflux was quantified using continuous intravenous infusion of 99mTc-HIDA.
  
  
  RESULTS
  The incidence of DGR after CDD was 67% compared to healthy control. In the majority of the patients the DGR was mild to moderate, but not with the clinical symptoms.
  
  
  CONCLUSIONS
  99mTc-HIDA scanning of the hepatobiliary system is a reasonable and reliable method for the quantitative evaluation of DGR. CDD is associated with a high incidence of DGR, but its occurrence does not produce significant clinical symptoms.
authors.affiliation: Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi Osaka Sayama, Osaka, Japan. Hashiline@aol.com
authors.forename: Naoki
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Tikao
authors.initials: T
authors.lastname: Yasuda
authors.forename: Masato
authors.initials: M
authors.lastname: Inayama
authors.forename: Hidemine
authors.initials: H
authors.lastname: Ho
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shinkai
authors.forename: Kenshu
authors.initials: K
authors.lastname: Kawanishi
authors.forename: Norihiko
authors.initials: N
authors.lastname: Hirai
authors.forename: Motohiro
authors.initials: M
authors.lastname: Imano
authors.forename: Hironori
authors.initials: H
authors.lastname: Shigeoka
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Imamoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shiozaki
mesh_terms: D000368:Aged; D002768:Choledochostomy / Q000009:adverse effects*; D004383:Duodenogastric Reflux / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019780:Technetium Tc 99m Lidofenin
chemical_list: D019275:Radiopharmaceuticals; D019780:Technetium Tc 99m Lidofenin