Use of Roux-en-Y diversion of duodenal secretions in the treatment of reflux gastritis

Abstract

Animal experiments and clinical studies suggest that duodenal secretions may be harmful to gastric mucosa after the antrum has been resected. Reflux of duodenal secretions into the gastric remnant after operation for ulcer disease may lead to the symptom complex of reflux gastritis. The injurious agent in the duodenal secretions has yet to be identified. Its relationship to altered gastric mucosa has not been fully elucidated. Diversion of the flow of duodenal secretions away from the stomach may relieve symptoms. Of several surgical procedures used, the Roux-en-Y limb has consistently afforded the best clinical result. Presented are 15 patients who had Roux-en-Y diversion for postoperative reflux gastritis. All patients showed marked improvement after this procedure. Twelve patients also had associated esophagitis. All original procedures were for benign ulcer disease. Three of the patients, who had Henley jejunal loop interpositions, continued to have symptoms which were relieved after conversion to a Roux-en-Y limb.