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Reconstructive procedure after distal gastrectomy to prevent remnant gastritis.
Hepatogastroenterology. 2004 Jul-Aug; 51(58):1215-8.H

Abstract

BACKGROUND/AIMS

Gastroduodenostomy (Billroth I) or gastrojejunostomy (Billroth II) after distal gastrectomy is associated with duodenogastric reflux and remnant gastritis. This study sought to determine which reconstructive procedure is least likely to cause remnant gastritis and to determine the correlation between duodenogastric reflux and remnant gastritis.

METHODOLOGY

Sixty patients who underwent curative distal gastrectomy for gastric cancer were classified into three groups by reconstructive procedure: group A, Roux-Y (n=18); group B, Billroth I (n=25); group C, Billroth II (n=17). Intragastric bile reflux was monitored using the Bilitec 2000 14 days after surgery, and endoscopy was performed and a patient questionnaire was completed 12 weeks after surgery.

RESULTS

Bile reflux occurred in 23.9%, 40.4%, and 73.4% of the time (p<0.001), and remnant gastritis developed in 33%, 76%, and 100% of patients (p<0.001), in groups A, B, and C, respectively. Helicobacter pylori infection did not correlate with remnant gastritis (p=0.57). Symptoms following Roux-Y reconstruction were comparable to those following Billroth I and II reconstructions.

CONCLUSIONS

Roux-Y reconstruction following distal gastrectomy is superior to Billroth I and II reconstruction in preventing remnant gastritis because it reduces duodenogastric reflux.

Links

clinical trials

Authors+Show Affiliations

Osugi H
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Fukuhara K
No affiliation info available
Takada N
No affiliation info available
Takemura M
No affiliation info available
Kinoshita H
No affiliation info available

MeSH

AgedAnastomosis, Roux-en-YDuodenogastric RefluxFemaleGastrectomyGastric StumpGastritisGastroenterostomyHumansIncidenceMaleMiddle AgedNeoplasm StagingReoperationStomach NeoplasmsSurveys and Questionnaires

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

15239282

Clinical Trial Links

A Study Comparing Billroth II With Roux-en-Y Reconstruction for Gastric Cancer

Citation

Osugi, H, et al. "Reconstructive Procedure After Distal Gastrectomy to Prevent Remnant Gastritis." Hepato-gastroenterology, vol. 51, no. 58, 2004, pp. 1215-8.
Osugi H, Fukuhara K, Takada N, et al. Reconstructive procedure after distal gastrectomy to prevent remnant gastritis. Hepatogastroenterology. 2004;51(58):1215-8.
Osugi, H., Fukuhara, K., Takada, N., Takemura, M., & Kinoshita, H. (2004). Reconstructive procedure after distal gastrectomy to prevent remnant gastritis. Hepato-gastroenterology, 51(58), 1215-8.
Osugi H, et al. Reconstructive Procedure After Distal Gastrectomy to Prevent Remnant Gastritis. Hepatogastroenterology. 2004 Jul-Aug;51(58):1215-8. PubMed PMID: 15239282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reconstructive procedure after distal gastrectomy to prevent remnant gastritis. AU - Osugi,H, AU - Fukuhara,K, AU - Takada,N, AU - Takemura,M, AU - Kinoshita,H, PY - 2004/7/9/pubmed PY - 2004/9/24/medline PY - 2004/7/9/entrez SP - 1215 EP - 8 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 51 IS - 58 N2 - BACKGROUND/AIMS: Gastroduodenostomy (Billroth I) or gastrojejunostomy (Billroth II) after distal gastrectomy is associated with duodenogastric reflux and remnant gastritis. This study sought to determine which reconstructive procedure is least likely to cause remnant gastritis and to determine the correlation between duodenogastric reflux and remnant gastritis. METHODOLOGY: Sixty patients who underwent curative distal gastrectomy for gastric cancer were classified into three groups by reconstructive procedure: group A, Roux-Y (n=18); group B, Billroth I (n=25); group C, Billroth II (n=17). Intragastric bile reflux was monitored using the Bilitec 2000 14 days after surgery, and endoscopy was performed and a patient questionnaire was completed 12 weeks after surgery. RESULTS: Bile reflux occurred in 23.9%, 40.4%, and 73.4% of the time (p<0.001), and remnant gastritis developed in 33%, 76%, and 100% of patients (p<0.001), in groups A, B, and C, respectively. Helicobacter pylori infection did not correlate with remnant gastritis (p=0.57). Symptoms following Roux-Y reconstruction were comparable to those following Billroth I and II reconstructions. CONCLUSIONS: Roux-Y reconstruction following distal gastrectomy is superior to Billroth I and II reconstruction in preventing remnant gastritis because it reduces duodenogastric reflux. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/15239282/Reconstructive_procedure_after_distal_gastrectomy_to_prevent_remnant_gastritis_ L2 - https://ClinicalTrials.gov/search/term=15239282 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -