LONG-TERM EFFECTS IN BILIODIGESTIVE SHUNTS

Duodenogastric reflux (DGR) and its effects were studied in patients w ith bile stones, operated by various bilio-digestive by-pass technique s, and followed up for 13-73 months. Ten patients underwent cholecyste ctomy and choledochoduodenostomy (CD), eight cholecystectomy and trans duodenal sphincteroplasty (TDS) and ten cholecystectomy and endoscopic papillotomy (EP). The control group consisted of eight patients who h ad undergone minor surgery. DGR was studied by Tc-99m-DISIDA scanning, and primary and secondary bile acids were assayed in reflux fluid. Th e effects were studied by gastroduodenoscopy and biopsies from the bod y of the stomach and antrum. Only patients operated by TDS (7/8) prese nted significant increases in DGR and bile acids (p<0.008). Half the p atients in this same group (4/8) had chronic atrophic gastritis and ma jor clinical disorders. Some physiopathological mechanisms possibly in volved in DGR and its effects are suggested.