The surgical treatment of postgastrectomy reflux gastritis.

Eighteen patients with postgastrectomy reflux gastritis were treated between 1970 and 1981 by Roux-en-Y diversion. All of the patients had a typical history of midepigastric burning pain and the majority had bilious vomiting as well. The diagnosis was confirmed by endoscopic results and histopathologic study of the gastric mucosa. Twelve surviving patients--one patient died postoperatively--experienced a dramatic relief of the symptoms. In five patients, gastrointestinal tract complaints reappeared but did not have the typical character of reflux gastritis. The macroscopically apparent gastritis subsided completely after revisional operations; while the histologic signs and symptoms of chronic gastritis remained. The Roux-en-Y diversion for patients with post-gastrectomy reflux gastritis proved to be a safe and relatively simple procedure with a high chance of relieving the complaints of the patient. The preoperative and postoperative gastric mucosal biopsies were not of much use in confirming the diagnosis or substantiation of the beneficial effect of the remedial operation.