Sinar D R, Flickinger E G, Park H K, Sloss R R
South Med J. 1985 Mar;78(3):255-8. doi: 10.1097/00007611-198503000-00006.
Surgical measures for the treatment of morbid obesity include gastric bypass of the stomach and duodenum. We endoscopically evaluated the bypassed segments in 51 patients three to 24 months after a standard gastric bypass procedure. Retrograde endoscopy was successful in 33 of the patients (65%). There was significantly more gastritis by endoscopic grading in the distal bypassed segment than in the proximal part of the stomach. The gastritis in the bypassed segment was associated with pooled bile in 97% of the patients. The severity of gastritis did not appear to be related to the time after surgery and was as severe three months after surgery as it was at 24 months. Histologically, the gastritis was nonconfluent, and often the histologic and endoscopic findings were at variance. There was intestinal metaplasia in biopsy specimens from the distal pouch in four of the 33 patients. The mechanism for the high incidence of gastritis is unknown, but may be related to decreased antral motility due to distention of the proximal pouch with food. These patients require close observation for changes in the bypassed segment of stomach that may occur as a consequence of chronic inflammation.
治疗病态肥胖的手术措施包括胃和十二指肠的胃旁路手术。我们对51例患者在标准胃旁路手术后3至24个月进行了内镜评估其旁路节段。逆行内镜检查在33例患者（65%）中成功。内镜分级显示，旁路节段远端的胃炎明显多于胃近端。97%的患者旁路节段的胃炎与胆汁淤积有关。胃炎的严重程度似乎与术后时间无关，术后3个月和24个月时一样严重。组织学上，胃炎不融合，组织学和内镜检查结果常不一致。33例患者中有4例远端囊袋活检标本出现肠化生。胃炎高发的机制尚不清楚，但可能与近端囊袋因食物扩张导致胃窦蠕动减弱有关。这些患者需要密切观察胃旁路节段可能因慢性炎症而发生的变化。
