Duodenogastric reflux (DGR) is a poorly
understood gastrointestinal process that is defined as reflux of duodenal
contents into the stomach. Therapeutic biliary procedures disrupt the function
of the sphincter of Oddi. Patients are potential “bile refluxers”. Methods: The
present study was carried out to document the incidence and evaluate the
clinical significance of DGR after cholecystectomy (n = 9) and choledochoduodenostomy
(CDD) (n = 6). Duodenogastric reflux was quantified using continuous
intravenous infusion of 99mTc-HIDA. They are studied by symptom
evaluation and hepatobiliary scintigraphy. The scintigraphic findings were then
compared with those of nine patients who had undergone cholecystectomy alone. Results:
The incidence of DGR after CDD was 67% compared to 22% in the cholecystectomy
alone group (P < 0.05). None of
the patients complained of epigastric distress. Conclusion: 99mTc-HIDA
scanning of the hepatobiliary system is a reasonable and reliable method for
the quantitative evaluation of DGR. CDD is frequently associated with mild to
moderate DGR compared to cholecystectomy alone group. We need to understand
these issues to adequately advise patients of the implications of
cholecystectomy and CDD.
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