Diagnosis and treatment of gastric paralysis after gastric operation / 中国康复理论与实践

@#ObjectiveTo investigate the diagnosis and treatment of gastric paralysis after gastric operation.MethodsThe clinical data of 21 patients with gastric paralysis after gastric operation were reviewed retrospectively.Results3.9% of patients occurred gastric paralysis in this group. The diagnosis was depended on patient's symptoms, X-ray graph of the upper digestive tract and gastroscopy. The patients were healed after conservative treatment.ConclusionThe combined conservative treatment is the ideal method to treat the gastric paralysis syndrome.

Use of Tc-99m Diisopropyl Iminodiacetic Acid (Tc-99m DISIDA) Scintigraphy for a Noninvasive Estimate of Bile Reflex after Gastric Operations

BACKGROUNDS:Bile reflux gastritis can occur when pylorus ablation is associated with bile stasis in the stomach. It can also occur with a gastrojejunostomy when bile is continuously poured into the gastric remnant after a vagotomy and an antrectomy. The diagnosis of bile reflux gastritis can be made only when the patient has bile gastritis documented on biopsy; the simple observation of a bile-stained mucosa in a gastric remnant is not sufficient to make the diagnosis of bile reflux gastritis. METHODS: Technetium-99m diisopropyl iminodiacetic acid (Tc-99m DISIDA) scintigraphy was used to study bile reflux into the gastric remnant in 31 patients with gastric operations. All patients had gastrofibroscopic biopsies in order to identify the bile reflux gastritis. RESULTS: Tc-99m DISIDA Scintigraphy identified bile reflux in 15 (83.2%) of 18 patients after a subtotal gastrectomy and a Billroth II gastrojejunostomy. Hewever, no bile reflux occured in either the 10 patients with a hemigastrectomy plus Billroth I gastoduodenostomy or the 3 patients with a truncal vagotomy plus pyloroplasty. Also, gastrofibroscopic biopsies identified bile reflux gastritis in only 3 patients (9.7%) with a subtotal gastrectomy plus Billroth II reconstruction. CONCLUSIONS: The patients who underwent a subtotal gastrectomy and Billroth II reconstruction showed higher bile reflux rates than did the patients who underwent a hemigastrectomy plus Billroth I reconstruction and a truncal vagotomy plus pyloroplasty (p<0.05). Also, only 9.7% of the postgastrectomy patients developed bile reflux gastritis.