DUODENOGASTROESOPHAGEAL REFLUX AFTER CHOLECYSTECTOMY
(Abstract):
The aim of the study was to establish by complementary methods the role of duodenogastroesophageal reflux diagnosed by spectrophotometry in the persistence of postcholecistectomy symptoms correlated with endoscopic lesions of esophageal mucosa. Material and methods: The clinical study was performed on a group of 238 patients divided into two groups: study (170 patients – 71.4%) and control group (68 patients – 28.6%). The study group was formed by patients with classic and laparoscopic cholecistectomy. The study group included 136 females (80%) and 34 males (20%), and the control group included 34 females (50%) and 34 males (50%). In the study group the average age was 54.40 ± 9.932 (SD) years, while in the control group the average age was 51.76 years ± 8.531 (SD). Both control and study group were endoscopically and spectrophotometrically (Bilitec®) examined. Results: The patients in the study group were previously cholecistectomized either by classic (136 cases – 80%) or laparoscopic method (34 cases – 20%);endoscopicaly, 60% cases were type A esophagitis (102 patients), 10% type A and hiatal hernia (17 patients), 10% type B esophagitis (17 patients) and 10% cases Barett esophagus (17 patients). For the control group we had 4.41% cases of hiatal hernia while the rest of 95.59% patients presented normal esophagus. Bilitec showed an mean values of number of refluxes for the study group of 8.000 ± 8.58098 (SD), much higher than the value identified for the control group – 1.7500 ± 0.83532 (SD). The number of long refluxes are much closer between the two groups – study group 2.000 ± 1.73717 (SD), control group 1.4853 ± 0.50350 (SD). Absorbency time > 0.14” is 292.4000 ± 229.941 (SD) for the study group while for the control group the average value is much more low (124.7500 ± 60.51061 (SD)). The values for the esophageal clearance are lower in the study group than in the control group: 77.6900 ± 86.01549 (SD), respectively 147.5250 ± 111.92144 (SD).
Conclusions:
Cholecistectomy can be included in the category of risk factors for alkaline duodenoesophageal reflux. The endoscopy
identified esophagitis lesions, hiatal hernia and Barett esophagus and the Bilitec test allowed the
identification
