Duodenogastric reflux following cholecystectomy in the dog: role of antroduodenal motor function

Nogi, Koji; Haruma, Ken; Taniguchi, Hiroshi; Yomota, Eiji; Okajima, Masazumi; Hananoki, Mutsumi; Hata, Jiro; Kusunoki, Hiroaki; Onoda, Yuichi

doi:10.1046/j.1365-2036.2001.01035.x

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…The cholecystoduodenal division of the hepatic bile changes from 50/50 in the healthy state to 20/80 in favor of the duodenum in the lithogenic state [49], i.e., in patients with gallstones about 80% of the hepatic bile enters the small intestine between meals. This higher amount of bile might induce a duodenogastroesophageal reflux via an increased frequency of pyloric relaxations, as has been demonstrated in dogs [51] and in cholecystectomized patients [52].…”

Section: Discussionmentioning

confidence: 67%

Increased Prevalence of Gallstone Disease and Impaired Gallbladder Motility in Patients with Barrett’s Esophagus

et al. 2007

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The prevalence of gallstones in patients with Barrett's esophagus (BE) and their gallbladder motility relative to that of healthy volunteers and GERD patients without BE were investigated. Of the 707 patients reviewed, 203 (125 males and 78 females) had BE. The prevalence of gallstones was significantly higher in the patients with BE than in those without BE (34 vs. 20%, respectively). The gallbladder functions of 22 patients with GERD, 27 patients with BE and 21 healthy volunteers were assessed by ultrasonography before and after a test meal. The patients with BE had significantly higher fasting volume and residual volume, but lower ejection volume, ejection fraction and ejection rate values than those of the healthy controls. None of the ultrasonographic parameters of patients without BE were significantly different from those of the controls. Patients with BE have a more complex gastrointestinal motility disorder that involves the gallbladder, and this makes this subset of patients with GERD more prone to gallstone disease.

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Section: Discussionmentioning

confidence: 67%

Increased Prevalence of Gallstone Disease and Impaired Gallbladder Motility in Patients with Barrett’s Esophagus

et al. 2007

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“…DGR and mechanisms of gastric mucosal injury was shown in several in vitro and in vivo animal studies (Eastwood 1975; Stein et al 1999; Nogi et al 2001). The destructive effect of duodenal content over the gastric mucosa is defined as reactive gastritis (Sobala et al 1993).…”

Section: Discussionmentioning

confidence: 96%

Cholecystectomy and duodenogastric reflux: interacting effects over the gastric mucosa

et al. 2016

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AimsTo evaluate association between duodenogastric reflux and early gastric mucosal changes before and after the cholecystectomy procedure.Materials and methodsPatients were evaluated with preoperative and postoperative endoscopy and endoscopic biopsy. Demographic and clinical characteristics, histological parameters, presence of duodenogastric reflux, and Updated Sydney scores were noted.ResultsA total of fifty patients who obeyed the follow-up were enrolled into the study. Median age of the patients was 43 years (range 25–84). Male–female ratio was 0.51 (17/33). Duodenogastric reflux % and Updated Sydney scores before and after cholecystectomy were 24 (48%) versus 39 (78%) and 2.38 ± 2.21 versus 3.46 ± 3.05, respectively (p = 0.001, p < 0.000). Mucosal inflammation degree showed significant increase in 15 (30%) patients, decrease in 7 (14%) patients and equality in 28 (56%) patients (p = 0.037). Neutrophil activation degree was significantly higher in 21 (42%) patients, lower in 5 (10%) patients after the surgery (p = 0.005). Postoperative glandular atrophy degree was also higher in 13 (26%) patients and equal in 37 (74%) patients (p = 0.001). Pre- and postoperative degree of intestinal metaplasia and H. pylori density did not any show significant difference (p = 0.157, p = 0.248, respectively).There were significant positive correlation between postoperative H. pylori infection and mucosal activity, inflammation, atrophy and intestinal metaplasia.ConclusionCholecystectomy is a potent inducer of pathologic duodenogastric reflux. Early onset of duodenogastric reflux and underlying H. pylori gastritis cause early gastric mucosal injury following cholecystectomy procedure by interacting collectively.

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“…Cholecystectomy also directly alters the motor function of the gastric antrum, pylorus and duodenum. In a dog model, cholecystectomy increased the bile salt content of the stomach and the frequency of pyloric relaxation during phase of the migrating motor complex [11]. These findings have been confirmed in humans with increased fasting gastric bile acid concentrations and lowered postcibal antral motility [12].…”

Section: Discussionmentioning

confidence: 63%

Duodenogastric Reflux after Biliary Procedure

Hashimoto¹

2014

OALib

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Duodenogastric reflux (DGR) is a poorly understood gastrointestinal process that is defined as reflux of duodenal contents into the stomach. Therapeutic biliary procedures disrupt the function of the sphincter of Oddi. Patients are potential "bile refluxers". Methods: The present study was carried out to document the incidence and evaluate the clinical significance of DGR after cholecystectomy (n = 9) and choledochoduodenostomy (CDD) (n = 6). Duodenogastric reflux was quantified using continuous intravenous infusion of 99m Tc-HIDA. They are studied by symptom evaluation and hepatobiliary scintigraphy. The scintigraphic findings were then compared with those of nine patients who had undergone cholecystectomy alone. Results: The incidence of DGR after CDD was 67% compared to 22% in the cholecystectomy alone group (P < 0.05). None of the patients complained of epigastric distress. Conclusion: 99m Tc-HIDA scanning of the hepatobiliary system is a reasonable and reliable method for the quantitative evaluation of DGR. CDD is frequently associated with mild to moderate DGR compared to cholecystectomy alone group. We need to understand these issues to adequately advise patients of the implications of cholecystectomy and CDD.

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Duodenogastric reflux following cholecystectomy in the dog: role of antroduodenal motor function

Cited by 9 publications

References 19 publications

Increased Prevalence of Gallstone Disease and Impaired Gallbladder Motility in Patients with Barrett’s Esophagus

Increased Prevalence of Gallstone Disease and Impaired Gallbladder Motility in Patients with Barrett’s Esophagus

Cholecystectomy and duodenogastric reflux: interacting effects over the gastric mucosa

Duodenogastric Reflux after Biliary Procedure

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