[Surgical treatment of duodeno-gastro-esophageal reflux disease: duodenal switch].
OBJECTIVE
To evaluate the efficacy of duodenal switch operation for patients with duodeno-gastroesophageal reflux disease.


METHODS
Four female patients with therapy resistant epigastric pain and biliary regurgitation were enrolled in the study. In all cases, abnormal duodeno-gastric reflux was confirmed by 24-hour Bilitec monitoring. The average age of the patients was 41.75 years (range 32-53) and three of them had a cholecystectomy in the past. Importantly, all patients had previously undergone fundoplication, which had to be repeated in one of them due to recurrent symptoms. More recently, a duodenal switch procedure was performed in these four patients. Their mean follow-up time was 24.25 months (range 21-30).


RESULTS
Duodenal switch was performed without any perioperative complications. A good clinical outcome was found in all patients on their follow up; however, an abnormal acidic exposure was found in one case on 24-hour oesophageal pH monitoring.


CONCLUSIONS
Recurrent epigastric complaints developing after anti-reflux surgery in patients with a previous diagnosis of gastroesophageal reflux disease might be due to an abnormal duodeno-gastric reflux. Previous cholecystectomy may increase the risk of biliary reflux. Duodenal switch procedure can be applied with good results in patients with therapy resistant abnormal duodeno-gastric reflux confirmed with Bilitec monitoring.
Varga
Gábor
G
Pécsi Tudományegyetem Altalános Orvostudományi Kar, Sebészeti Klinika, 7643 Pécs, Ifjúság u. 13. gvarga@iseb.pote.hu
Cseke
László
L
Kalmár
Katalin
K
Horváth
Ors Péter
OP
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods; D004383:Duodenogastric Reflux / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome