Duodenogastric reflux after choledochoduodenostomy: evaluation by technetium-99m scintigraphy.
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.
Hashimoto
Naoki
N
Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi Osaka Sayama, Osaka, Japan. Hashiline@aol.com
Yasuda
Tikao
T
Inayama
Masato
M
Ho
Hidemine
H
Shinkai
Masayuki
M
Kawanishi
Kenshu
K
Hirai
Norihiko
N
Imano
Motohiro
M
Shigeoka
Hironori
H
Imamoto
Haruhiko
H
Shiozaki
Hitoshi
H
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
D019275:Radiopharmaceuticals; D019780:Technetium Tc 99m Lidofenin