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PubMed1980

Alkaline reflux gastritis: a reevaluation.

The results of Roux-Y reconstruction in 46 patients diagnosed as having alkaline reflux gastritis were analyzed to determine which factors in the preoperative evaluation were associated with a good clinical result after surgery. The operation was considered successful in 30 (65 percent) of the 46 patients. Success was not related to the details of the patient's symptoms, the visible appearance of the gastric mucosa at endoscopy or the extent of histologic abnormalities in a preoperative biopsy or resected specimen of gastric mucosa. Therefore, the outcome of surgery could not be predicted from preoperative findings, and gastritis, even though it is often present, is not likely to be responsible for the symptoms in this syndrome. Nevertheless, the results of surgery for postgastrectomy bile vomiting and abdominal pain are good enough that when other conditions have been ruled out, Roux-Y reconstruction can be recommended for patients with severe complaints.

Bile↗
PubMed1964

CANDIDA SEPTICEMIA.

Explore the source record for details and available documents.

Acute Kidney Injury↗
PubMed1988

Clinical and radionuclide evaluation of Roux-Y diversion for postgastrectomy dumping.

From 1973 to 1986, 22 patients underwent Roux-Y gastrojejunostomy for the early postgastrectomy dumping syndrome. In the early years, five patients underwent Roux-Y conversion with the addition of a 10 cm antiperistaltic jejunal segment interposed between the Roux-Y limb and the stomach. Within 4 years, all five patients had the jejunal segment removed due to severe symptoms of gastric retention. These patients underwent reconstruction to create Roux-Y limb only and joined the pool of 17 patients who underwent Roux-Y diversion only for the dumping syndrome. Overall, 19 of 22 patients (86 percent) had almost complete resolution of their dumping symptoms on long-term follow-up. Three patients showed no improvement, two with severe gastric retention and one with recurrent dumping symptoms. Overall, 5 of 22 patients (23 percent) had moderate to severe early and late postoperative gastric retention necessitating medical treatment in three and subsequent near-total gastrectomy in two. Although other procedures such as pyloric reconstruction or the addition of isoperistaltic or antiperistaltic jejunal interpositions have been reported to be equally successful in delaying gastric emptying and resolving dumping symptoms, we have preferred Roux-Y diversion for the treatment of combined alkaline reflux gastritis and dumping or the pure early vasomotor postgastrectomy dumping syndrome. As reported, we have abandoned the use of an antiperistaltic jejunal segment interposed between the stomach and the Roux-Y limb due to the high rate of postoperative gastric retention.

Anastomosis, Roux-en-Y↗
PubMed1983

Intestinal pacing for canine postgastrectomy dumping.

Our aim was to determine whether or not postprandial retrograde duodenal pacing would abolish the canine postgastrectomy dumping syndrome. Five dogs underwent truncal vagotomy, distal hemigastrectomy, gastroduodenostomy, and circumferential proximal duodenal myotomy to facilitate pacing. Bipolar stimulating electrodes from an implanted pacing unit were attached to the bowel 35 cm distal to the gastroduodenostomy, and six monopolar recording electrodes were applied at 5-cm intervals proximal to the pacing electrodes. After recovery, gastric emptying was assessed in the fasted conscious dogs using 300-ml gastric instillates of 25% dextrose marked with [14C]polyethylene glycol, while pulse, hematocrit, and defecation were monitored. Each dog underwent five tests with and five tests without retrograde duodenal pacing. Without pacing, the dogs emptied a mean +/- SEM of 237 +/- 14 ml of the instillate by 20 min and developed tachycardia (change in pulse, 45 +/- 4), hemoconcentration (change in hematocrit, 8 +/- 1), and diarrhea in 13 of 25 tests. Retrograde duodenal pacing slowed gastric emptying (157 +/- 20 ml, p less than 0.05) and minimized the adverse cardiovascular sequelae (change in pulse, 25 +/- 5, change in hematocrit, 6 +/- 1; p less than 0.05) and the diarrhea (only 2 of 25 tests, p less than 0.01). We concluded that intestinal pacing ameliorated the postgastrectomy dumping syndrome in dogs. Such an approach may be applicable to humans.

Action Potentials↗