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Ann Thorac Surg 1978;26:563-573
© 1978 The Society of Thoracic Surgeons

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Articles

Gastroesophageal Reflux Following Gastric Operation

Departments of Surgery, Women's College Hospital and the University of Toronto, Toronto, Ont, Canada

^* Address reprint requests to Dr. Henderson, Women's College Hospital, 76 Grenville St, Toronto, Ont, Canada M5S 1B2.

The combination of previous gastric operation and gastroesophageal reflux produces major difficulties in obtaining effective symptomatic relief. Seventy patients were studied by history, radiology, endoscopy, and esophageal manometry before surgical reflux control. Twenty-eight had had vagotomy and pyloroplasty; 4, vagotomy and gastroenterostomy; 11, Billroth I gastrectomy; and 27, Billroth II gastrectomy.

In all patients reflux control was accomplished by hernia repair, and in 14 patients bile diversion was added for control of bile gastritis. A variety of reflux control operations were used. However, the most effective results were achieved with total fundoplication gastroplasty, and in this group of 22 patients there has been no anatomical recurrence and no reflux. The partial fundoplication gastroplasty (Belsey type) was ineffective in reflux control and should not be used in patients who have had a previous gastric procedure.

Reflux control and, when necessary, bile diversion give effective relief to patients with bile gastritis and esophageal reflux following gastric operation.

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