An experimental study was conducted to evaluate the effect of different fractions (bile and pancreaticoduodenal secretions) on the gastric stump and esophageal mucosa. Twenty pigs underwent partial gastrectomy (two-third distal) and cardiomyotomy in order to induce free gastroesophageal reflux. Then, reconstruction of the alimentary tract was performed to assess the effects of different types of alkaline reflux. A combined (biliary and pancreaticoduodenal) reflux, an isolated biliary reflux, and an isolated pancreaticoduodenal reflux were induced, respectively, in three different groups of five pigs each. In a control group a Roux-en-Y gastrojejunostomy was performed. Nine months later, the animals were sacrificed; the esophagus and the gastric stump were removed for histologic examination. The results show that the most severe histopathological lesions are determined by combined alkaline reflux; on the other hand, separated fractions can induce only mild changes on the gastric stump and esophageal mucosa.
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