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Background. The aim of this study was to determine whether increased duodenograstric reflux contributes
to postcholecystectomy symptoms.
Methods. Gastric pH monitoring, hepatobiliary scintigraphy, gastric emptying scans, and gastric
acid analysis were performed in asymptomatic (n=10) and in symptomatic (n=27) patients
after cholecystectomy. Normal subjects (n=20), patients with dyspepsia related to
gastric acid hypersecretion (n=20), patients with reflux gastritis after gastric surgery
(n=10), and patients with confirmed primary pathologic duodenogastric reflux (n=10)
were studied as controls. Symptomatic patients also underwent upper gastrointestinal
endoscopy.
Results. Symptomatic patients had significantly increased interprandial gastric exposure to
pH<3 compared with asymptomatic subjects, which correlated well with a high incidence
of hepatobiliary scans positive for abnormal duodenogastric reflux and chronic gastritis
on endoscopy. Gastric alkaline exposure in symptomatic patients was similar to that
seen in patients with primary pathologic duodenogastric reflux and patients with duodenogastric
reflux related to gastric surgery. Gastric acid secretion and gastric emptying were
not altered. Five patients tested before and after laparoscopic cholecystomy showed
that nocturnal gastric alkalization was enhanced after operation.
Conclusions. This study suggests that excessive duodenogastric reflux may be responsible for persistence
of symptoms after cholecystectomy.
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Article info
Publication history
Accepted:
August 30,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
