Evaluation of esophageal bile reflux after total gastrectomy by gastrointestinal and hepatobiliary dual scintigraphy |
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Authors: | Shinya Adachi Tohoru Takeda Katashi Fukao |
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Institution: | (1) Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575 Tsukuba-shi, Japan;(2) Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575 Tsukuba-shi, Japan |
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Abstract: | Conducting the qualitative evaluation of reconstruction methods is difficult because of their complexity. The aim of the present
study was to compare esophageal bile and food reflux by performing gastrointestinal and hepatobiliary dual scintigraphy (GHDS)
after various methods of reconstruction following total gastrectomy. Of 17 patients studied, 4 had undergone Roux-en-Y anastomoses
(R-Y); 6, jejunal pouch-Y anastomoses (P-Y); and 7, jejunal pouch interposition (P-I). GHDS was performed 1 year after surgery
using111In-diethylene triamine pentaacetic acid administered orally, and99mTc-pyridoxyl-5-methyl tryptophan administered intravenously. Imaging data from a gamma camera were stored in and processed
by a data analyzer. Three patients who had undergone R-Y and one who had undergone P-I complained of heartburn, while one
who had undergone R-Y, two who had undergone P-Y, and three who had undergone P-I complained of a feeling of fullness. Esophageal
bile reflux was confirmed by GHDS in four of the patients who had undergone R-Y, one who had undergone P-Y, and four who had
undergone P-I. Moreover, GHDS demonstrated food retention in two patients who had undergone R-Y, five who had undergone P-Y,
and four who had undergone P-I. Weight loss was closely related to the esophageal reflux of bile or food which can be accurately
detected by GHDS. Despite the absence of heartburn, patients diagnosed as having bile reflux by GHDS showed poor recovery
of body weight. |
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Keywords: | bile reflux heartburn reconstruction after total gastrectomy gastrointestinal and hepatobiliary dual scintigraphy |
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