Incidence and Risk Factors of Reflux Esophagitis after a Subtotal Gastrectomy.
- Author:
Seung Joo KANG
1
;
Mi Na KIM
;
Su Hyun KIM
;
Jin Myung PARK
;
Hyun Jin JO
;
Mun Sun CHOI
;
Sang Hyub LEE
;
Young Soo PARK
;
Jin Hyeok HWANG
;
Jin Wook KIM
;
Sook Hyang JUNG
;
Nayoung KIM
;
Dong Ho LEE
;
Hyun Chae JUNG
;
In Sung SONG
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Reflux esophagitis;
Subtotal gastrectomy;
Bile reflux;
Helicobacter pylori
- MeSH:
Bile Reflux;
Esophagitis, Peptic;
Follow-Up Studies;
Gastrectomy;
Gastritis;
Gastroenterostomy;
Helicobacter;
Helicobacter pylori;
Humans;
Incidence;
Los Angeles;
Obesity;
Retrospective Studies;
Risk Factors
- From:Korean Journal of Gastrointestinal Endoscopy
2008;37(4):243-252
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The aims of this study were to evaluate the incidence of reflux esophagitis in patients after a subtotal gastrectomy and to determine risk factors for reflux esophagitis. METHODS: Among 225 patients who underwent a subtotal gastrectomy from June 2003 to December 2004 at Seoul National University Bundang Hospital, 201 patients who received follow-up for more than six months and underwent at least one endoscpoic examination were retrospectively reviewed. We used the Los Angeles (LA) classification system and included a minimal change for reflux esophagitis. RESULTS: There were 173 patients who underwent a Billroth I procedure and 28 patients who underwent a Billroth II procedure. The cumulative incidence of reflux esophagitis was 40.8%. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03), bile reflux gastritis (p<0.01) and postoperative obesity (p=0.02) were significant risk factors for the development of reflux esophagitis including a minimal change. The number of postoperative endoscopies > or =4 (p=0.012), bile reflux gastritis (p=0.002) and postoperative obesity (p=0.038) were risk factors for a minimal change. A patient age > or =65 years (p=0.04), a follow-up duration > or =40 months (p=0.03) and Helicobacter pylori eradication before surgery (p<0.01) were independent risk factors for LA grade A/B reflux esophagitis. CONCLUSIONS: Bile reflux gastritis is a risk factor for the development of reflux esophagitis after a subtotal gastrectomy. Preoperative helicobacter eradication is also associated with reflux esophagitis, except for a minimal change, but further studies are needed.
