24 hours gastric pH metry in patients with distal partial gastrectomy

Background: Duodenogastric reflux after distal patrial gastrectomy is associated with various symptoms that are often detrimental to patients' quality of life. There is the question whether the gastric content is acidic or mixed and how cure it?

Methods: In total 60 patients who had undergone gastrectomy 33 had Billroth I, 27 had Billroth II resections, and 20 healthy controls were entered in study. The mean age: 63±9,9 year, 35 women and 45 men. All investigated patients underwent gastroduodenoscopy and 24-h gastric pH monitoring. The results of different groups were compared and statistically evaluated with c2 test.

Results: The Billroth I group had a significantly higher mean acidity during 24 hours gastric pH metry than that in Billroth II group and in healthy controls (512,3±145min v.210±170min v. 412±207min) while the Billroth II group acidity results were significantly lower than in Billroth I group and healthy volunteers. There were no significant difference between patients resected because of ulcer disease and those resected because of distal gastric malignomas (319±98min v. 330,4±107min).

Conclusion: Symptoms were more frequently associated with hyperacidity than with mixed or bile reflux in Billroth I. group, while in Billroth II group rather the mixed and bile refluxate. Combined monitoring of pH and bilirubin more accurately determines the nature of the refluxate, and may help in the management of these patients.