DUODENOGASTRIC REFLUX AFTER CHOLEDOCHODUODENOSTOMY

Duodenogastric reflux (DGR) has been implicated in several disease pro cesses, The present study was carried out to document the incidence an d evaluate the clinical significance of DGR after choledochoduodenosto my (CDD). A total of 13 patients who had undergone cholecystectomy wit h a standard side-to-side CDD for choledocholithiasis or chronic pancr eatitis were studied by symptom evaluation, scintigraphy, endoscopy, a nd gastric mucosal histology at least 6 months after surgery. The scin tigraphic findings were then compared with those of 10 patients who ha d undergone cholecystectomy alone, Only two patients (15%) had mild dy speptic symptoms. The incidence of DGR after CDD was 69% compared to 2 0% in the cholecystectomy alone group (P < 0.05). In the majority of p atients the DGR was only mild to moderate and the severity correlated well with the degree of endoscopic gastritis, but not with the clinica l symptoms or histological findings. These results indicate that while CDD is associated with a high incidence of DGR, its occurrence does n ot produce significant clinical symptoms.