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Bile diversion after total gastrectomy

✍ Scribed by I. A. Donovan; J. W. L. Fielding; H. Bradby; M. Sorgi; L. K. Harding

Publisher
John Wiley and Sons
Year
1982
Tongue
English
Weight
230 KB
Volume
69
Category
Article
ISSN
0007-1323

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✦ Synopsis

Abstract

A method for studying bile reflux into the oesophagus after total gastrectomy is described using 99Tcm-HIDA and an external imaging system. Two reconstructions were studied: oesophagojejunostomy with a diverting entero-anastomosis (omega reconstruction, 6 studies) and Roux-en-Y reconstruction (20 studies). The incidence of reflux on scanning correlated well with the incidence of oesophagitis, and the finding of reflux was almost always associated with severe symptoms. The omega procedure was unsuccessful in diverting bile in 5 patients despite an entero-anastomosis as wide as 12 cm. The Roux-en-Y reconstruction was unsuccessful in diverting bile in 5 patients all of whom had a diverting limb 35 cm in length; none of the 9 patients with a diverting limb longer than 35 cm refluxed (range 40–50 cm).

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