J.Jpn. Surg. Soc.. 89(3): 336-344, 1988

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Original article

EFFECTS OF DUODENOGASTRIC BILE REFLUX ON GASTRIC MUCOSAL HEXOSAMINE CONCENTRATIONS AFTER SELECTIVE PROXIMAL VAGOTOMY OR EXTENDED DISTAL GASTRECTOMY FOR DUODENAL ULCER

Effects of duodenogastric reflux (DGR) of bile on hexosamine concentrations in gastric mucosa were studied in 17 healthy controls and 133 patients with duodenal ulcer patients before and after surgery. Total bile acid concentration in gastric juice was measured using enzyme method to estimate DGR. Mucosal hexosamine concentration of the biopsy specimens taken from the gastric corpus and antrum was measured according to Boas's method. The operative procedures included selective proximal vagotomy (SPV) with or without pyloroplasty, and extended distal gastrctomy with Billroth I (BI) or II (BII) anastomosis. The rate of DGR were significantly higher in cases after gastrectomy, especially in BII cases than in cases after SPV. In the early postoperative period after SPV with or without pyloroplasty, DGR was increased significantly. However, the reflux rate was decreased gradually to the preoperative level thereafter, suggesting that normal function of gastric emptying might be recovered with time. The hexosamine concentration of the antral mucosa showed clearly an inverse relationship to the changes in DGR rate. These results suggested that SPV could be the more physiological procedure than gastrectomy from the point of DGR.

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