Gastric surgery is not a risk factor for erosive esophagitis or Barrett's esophagus.
作者信息
Akiyama Tomoyuki, Inamori Masahiko, Akimoto Keiko, Iida Hiroshi, Endo Hiroki, Hosono Kunihiro, Ikeda Tamon, Sakamoto Yasunari, Fujita Koji, Yoneda Masato, Koide Tomoko, Takahashi Hirokazu, Tokoro Chikako, Goto Ayumu, Abe Yasunobu, Kobayashi Noritoshi, Kubota Kensuke, Saito Satoru, Moriya Akihiko, Rino Yasushi, Imada Toshio, Nakajima Atsushi
机构信息
Department of Gastroenterology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
出版信息
Scand J Gastroenterol. 2010 Apr;45(4):403-8. doi: 10.3109/00365520903536507.
OBJECTIVE
The role of gastric acid reflux is difficult to separate from that of pancreatic-biliary reflux in the pathogenesis of erosive esophagitis (EE) and Barrett's esophagus (BE). Gastric surgery patients provide a good model for both significant pancreatic-biliary reflux and marked gastric acid inhibition. We assessed the risk of EE and BE after distal gastrectomy in a case-controlled study.
MATERIAL AND METHODS
One hundred and sixty patients (121 men, 39 women; median age 68 years; range 32-86 years) with distal gastrectomies (Billroth-I) and 160 sex- and age-matched controls with intact stomachs were enrolled. The presence of EE and BE were diagnosed based on the Los Angeles Classification and the Prague C & M Criteria, respectively. A conditional logistic regression model with adjustments for potential confounding factors was used to assess the associations.
RESULTS
According to the multivariate analyses, patients with distal gastrectomies tended to have inverse associations with the risks of EE and BE, and the inverse association with the risk of BE reached a significant level.
CONCLUSIONS
Distal gastrectomy is not a risk factor for the development of EE and BE. This lack of a positive association between distal gastrectomy and EE and BE may suggest that pancreatic-biliary reflux with a limited amount of acid is not sufficient to damage the esophageal mucosa.
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