ISOPERISTALTIC JEJUNAL INTERPOSITION FOR INTRACTABLE POSTGASTRECTOMY ALKALINE REFLUX GASTRITIS

BACKGROUND: The Roux-en-Y gastrojejunostomy is a popular method in the operative treatment of alkaline reflux gastritis and other postgastre ctomy sequelae, but is associated with a high incidence of the so-call ed ''Roux stasis syndrome.'' The Henley jejunal interposition has been used occasionally, albeit not widely, as an alternative to the Roux-e n-Y reconstruction. STUDY DESIGN Six patients underwent Henley gastroj ejunoduodenostomy to treat severe (Visick grade IV) symptoms following Billroth I and II procedures for peptic ulcer disease. Ah interposed jejunal segments were 40 cm in length and isoperistaltic in orientatio n. Ah patients had follow-up examination and telephone interview (mean 4.3 years, range 2.2 to 7.8 years). RESULTS: Ah patients noted dramat ic improvement after remedial surgery in the first year of follow-up. After the first postoperative year, all patients remained virtually sy mptom-free (Visick grade I and II) with no complaints of gastrojejunal stasis or bile acid reflux. CONCLUSIONS: This experience suggests tha t the Henley jejunal interposition is our effective method of treating reflux gastritis and is not associated with the poor emptying frequen tly associated with the Roux-en-Y reconstruction.