title: Analysis of esophageal reflux after proximal gastrectomy measured by wireless ambulatory 24-hr esophageal pH monitoring and TC-99m diisopropyliminodiacetic acid (DISIDA) scan.
abstract: OBJECTIVE
  Reflux is one of the most common sequela after proximal gastrectomy (PG). The aim of this study was to find a predicting factor related to the character of esophageal reflux after PG.
  
  
  METHODS
  Wireless ambulatory 24-hr pH monitoring (for acid reflux, AR) and diisopropyliminodiacetic acid hepatobiliary scan (for bile reflux, BR) were performed on 24 patients who had reflux symptoms after PG with esophagogastrostomy from July 2008 to March 2009. Endoscopic examination was done and the length of remnant stomach (LoRS) was measure by postoperative UGI series.
  
  
  RESULTS
  Eleven patients (45.8%) had only BR, 7 (29.2%) had AR only, Two patients (8.3%) had both acid and BR, and 3 (12.5%) had neither. The LoRS along greater curvature was significantly shorter in patients with only BR (16.11 +/- 2.87 cm) than in patients with only AR (23.69 +/- 6.15 cm, P = 0.003). Severity of symptoms or esophagitis was not significantly correlated with the content of acid or BR.
  
  
  CONCLUSIONS
  Reflux symptom after PG is caused by either bile or acid rather than both. Character of reflux was related to the LoRS.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Hongman
authors.initials: H
authors.lastname: Yoon
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kong
authors.forename: Joo-Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Jin Chul
authors.initials: JC
authors.lastname: Paeng
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
mesh_terms: D001655:Bile Reflux / Q000000981:diagnostic imaging*; D050782:Esophageal pH Monitoring / Q000009:adverse effects / Q000295:instrumentation; D004945:Esophagoscopy; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D019785:Technetium Tc 99m Disofenin
chemical_list: D019275:Radiopharmaceuticals; D019785:Technetium Tc 99m Disofenin