Korean J Gastrointest Endosc > Volume 17(6); 1997 > Article

Korean Journal of Gastrointestinal Endoscopy 1997;17(6): 743-749.

원저 : 식도 위장관 ; 위절제술 후 발생한 내시경적 역류성 위염 및 식도염 - 임상적 의미와 술식에 따른 차이 - ( Original Articles : Esophagus , Stomach & Intestine ; Endoscopic Alkaline Reflux Gasitritis and Esophagitis in Gastroresected Patients )

정준오, 김유선, 문선희, 황진혁, 우광훈, 김진, 장동경, 정현채, 송인성, 최규완, 김정룡 (Jun Oh Jung, You Sun Kim, Sun Hi Moon, Jin Hyok Hwang, Gwang Hoon Woo, Jin Kim, Dong Kyung Chang, Hyun Chae Jung, In Sung Song, Kyoo Wan Choi and Chung Yong Kim)

Abstract

Background/Aims:
The reflux alkaline gastritis and esophagitis are important late complications after gastric surgery. Endoscopy is primary diagnostic tool for them. But, the clinical significance of gastritis and esophagitis diagnosed by endoscopy is not well known. We evaluated the correlation between the alkaline reflux gastritis and esophagitis and their symptoms and we also examined their prevalence according to types of surgery.
Methods:
The 111 gastroresected patients who had had upper endoscopy by one endoscopist were evaluated. We reviewed all their medical records, and interviewed 54 patients by telephone to evaluate symptoms.
Results:
Endoscopic reflux alkaline gastritis was observed in 38 patients(45%) with Billroth- II gastrectomy and in 4 patients(33%) with Bil]roth- I gastrectomy. But, there was no symptomatic difference between group with and without endoscopic reflux gastritis. Moreover, none of them had typical reflux gastritis symptom complex including billous vomiting. In all patients with total gastrectomy and loop esophagojejunostomy, endoscopic reflux esophagitis was observed. But, there was no case af endoscopic reflux esophagitis in the patients with total gastrectomy and Roux-en-Y anastomosis. There was significant symptomatic correlation between group with and without endoscopic reflux esophagitis. T'he incidence of reflux esophagitis had no difference between Billroth- II gastrectomy and Billroth- I gastrectomy.
Conclusion:
The endoscopic alkaline reflux gastritis had poor symptematic correlation. In the case of total gastrectomy, for the prevention of reflux esophagitis, Roux-en-Y anastomosis is better than loop esophagojejunostomy. (Korean J Gastrointest Endosc 17: 743-749, 1997)

Key Words: Reflux alkaline gastritis , Reflux alkaline esophagitis , Gastrectomy