[Evaluation of esophageal motility after its resection and extensive devascularization].

UNLABELLED

Almost complete lack of information concerning esophageal motility after non-shunt operations due to bleeding esophageal varices was the main stimulus of this study. Thirty seven patients from 112 treated for bleeding esophageal varices in our Clinic in the years 1993-1997, were studied. To evaluate esophageal parameters the Autronic GmbH D-7500 pH-meter, and from 1995, the Microdigitrapper 2 MB (Synectics) System were used. The latter enables 24-hour, simultaneous pH and pressure measurements. In patients before operation, and those who did not undergo surgery (24 measurements), reflux occurred in 14 (58%). In 10, the varices were qualified to gr. III and IV according to Paquet's classification. Five cases of mixed (supine/upright) reflux was observed. Among 9 patients subjected to previous sclerotherapy, 4 had reflux. Ph parameters in 14 patients examined before and after operation did not differ significantly. 24-hour pressure monitoring was performed in 24 patients. Eight were examined before and after operation. All pre and postoperative results were compared. No statistic differences were found.

CONCLUSION

1. Gastroesophageal reflux is frequent in cirrhotic patients with varices, and concerns over 50% of them. 2. No significant differences between pre and postoperative results, suggest that extensive devascularisation and esophageal transection do not affect esophageal motility significantly. 3. 24-hour combined pH and manometry is an extremely helpful method of obtaining objective motility data.