Sa1331 RETROSPECTIVE CLINICAL STUDY FOR REFLUX ESOPHAGITIS WITH/WITHOUT GASTRECTOMY IN JAPANESE PATIENTS:RELATIONSHIP BETWEEN THE METHODS OF GASTRECTOMY AND THE GRADE OF REFLUX ESOPHAGITIS

Abstract

The cause of reflux esophagitis after total/partial gastrectomy is considered to be the reflux of gastric juice (acid) or/and duodenal juice (alkali). It is reported that the incidence of reflux esophagitis is low after total gastrectomy, and Roux-Y method is lower than Billroth I/II method. We investigated the relationships between incidence/severity of reflux esophagitis and surgical procedures of total/partial gastrectomy in Japanese patients. We subjected the patients who have undergone Esophagogastroduodenoscopy (EGD) for these 10 years and diagnosed with reflux esophagitis (RE) in Grade A to D by Los Angeles classification. We compared the severity of reflux esophagitis with/without history of upper gastrointestinal surgery, and also examined the relationship between the method of gastrectomy and the grade of reflux esophagitis. We performed 44843cases of EGD in these 10 years, and diagnosed 4771 cases of RE (322 in postoperative group vs 4449 in control group). Table 1. Backgroud of patients: In this study, we excluded the cases with local gastrectomy, pancreatoduodenectomy, unknown surgical procedure, and subjected 264 cases (male 197, female 67). Table 2. Relationship between the methods of gastrectomy and the grade of reflux esophagitis. The endoscopic grade of reflux esophagitis was relatively high in cases after total gastrectomy. In those cases, a subjective symptom of reflux was slightness. In Japanese patients after total gastrectomy, a subjective symptom of reflux is slightness, but the grade of reflux esophagitis is severe. So it is necessary to evaluate the grade of reflux esophagitis by EGD and treat it appropriately.View Large Image Figure ViewerDownload Hi-res image Download (PPT)