A COMPOSITE SCORE OF ENTEROGASTRIC REFLUX QUANTITATION ON TC-99M-HIDASCINTIGRAPHY

Background/Aim: Enterogastric reflux of bile, and duodenal and pancrea tic secretions may occur either spontaneously or, more commonly, after gastric surgery. The most reliable method in discriminating symptomat ic from asymptomatic postgastric surgery refluxers, and in, predicting a good clinical result after surgical diversion in. the former group, is the quantitation of reflux by Tc-99m-HIDA scintigraphy. Materials and Methods: In 28 normal subjects and 143 postgastric surgery patient s, the enterogastric reflux (EGR) was demonstrated by Tc-99m-HIDA scin tigraphy on 230 occasions. The EGR index was quantitated according to two different formulae: the former one based on the amount of refluxat e (percentage of maximal radioactivity of the gastric area over the to tal abdominal activity - EGR-I-m) and the latter one based on. the amo unt and the duration of the time of reflux (CompEGR-I-m) and represent ing the area of the surface below the curve, which teas yield by plott ing EGR-I-m values (obtained every 5 min for one hour) against time. R esults: Although there was a highly significant correlation of values between the two methods (p<0.0000001), the latter one was more reliabl e in classifying postgastric surgery patients according to the presenc e of reflux symptoms and the reflux index. Conclusions: In patients wi th a CompEGRpI(m)>770 and postgastric surgery symptoms, at least some of the symptoms can. be safely be attributed to enterogastric reflux.