TY - JOUR
T1 - Duodenogastric reflux and gastric histology after cholecystectomy with or without sphincteroplasty
AU - Lorusso, D.
AU - Pezzolla, F.
AU - Montesani, C.
AU - Giorgio, P.
AU - Caruso, M. L.
AU - Cavallini, A.
AU - Guerra, V.
AU - Misciagna, G.
PY - 1990
Y1 - 1990
N2 - Sixteen patients who had undergone cholecystectomy plus sphincteroplasty, 14 cholecystectomized patients and ten control patients were studied to evaluate whether differences existed in duodenogastric reflux and whether these were related to morphological damage of the gastric mucosa. Duodenogastric bile reflux during fasting was evaluated by measuring the concentration of total bile acids (by an enzymatic method) and single bile acids in the gastric juice by high performance liquid chromatography. The damage was evaluated histologically by systematic endoscopic biopsy of the antrum and body of the stomach. There was a statistically significant difference in fasting bile reflux between the three groups (Kruskal-Wallis test, P <0.001), and the group that underwent cholecystectomy plus sphincteroplasty had a significantly higher median value than the cholecystectomized group (P <0.05) and the control group (P <0.01). The distribution of chronic antral atrophic and superficial gastritis was different in the three groups (χ2 test, P <0.005). Chronic atrophic gastritis was associated with cholecystectomy plus sphincteroplasty (P <0.01), while chronic superficial gastritis was more frequent in cholecystectomized patients. These results suggest that there may be more duodenogastric reflux after cholecystectomy plus sphincteroplasty than after cholecystectomy alone, and that there may be a correlation between the amount of duodenogastric reflux and the severity of mucosal damage.
AB - Sixteen patients who had undergone cholecystectomy plus sphincteroplasty, 14 cholecystectomized patients and ten control patients were studied to evaluate whether differences existed in duodenogastric reflux and whether these were related to morphological damage of the gastric mucosa. Duodenogastric bile reflux during fasting was evaluated by measuring the concentration of total bile acids (by an enzymatic method) and single bile acids in the gastric juice by high performance liquid chromatography. The damage was evaluated histologically by systematic endoscopic biopsy of the antrum and body of the stomach. There was a statistically significant difference in fasting bile reflux between the three groups (Kruskal-Wallis test, P <0.001), and the group that underwent cholecystectomy plus sphincteroplasty had a significantly higher median value than the cholecystectomized group (P <0.05) and the control group (P <0.01). The distribution of chronic antral atrophic and superficial gastritis was different in the three groups (χ2 test, P <0.005). Chronic atrophic gastritis was associated with cholecystectomy plus sphincteroplasty (P <0.01), while chronic superficial gastritis was more frequent in cholecystectomized patients. These results suggest that there may be more duodenogastric reflux after cholecystectomy plus sphincteroplasty than after cholecystectomy alone, and that there may be a correlation between the amount of duodenogastric reflux and the severity of mucosal damage.
KW - cholecystectomy
KW - duodenogastric reflux
KW - sphincteroplasty
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U2 - 10.1002/bjs.1800771136
DO - 10.1002/bjs.1800771136
M3 - Article
C2 - 2253017
AN - SCOPUS:0025241986
VL - 77
SP - 1305
EP - 1307
JO - British Journal of Surgery
JF - British Journal of Surgery
SN - 0007-1323
IS - 11
ER -