Surgical management of alkaline reflux gastritis

A. C. Fiore, M. A. Malangoni, T. A. Broadie, J. A. Madura and J. E. Jesseph

Fifty-six patients were treated surgically for alkaline reflux gastritis, in each a consequence of subtotal gastrectomy and vagotomy for ulcer disease. Of these, 41 available for follow-up, 18 of whom had had Henley loop jejunal interpositioning and the remaining 23 Roux-en-Y (long-loop) gastroenterostomy. The conditions of most patients improved with respect to reflux symptoms of pain, vomiting, and weight loss, but the patients with Roux-en-Y procedure had uniformly better results that did those with the Henley loop. Although the Henley loops in this series of patients may have been too short to be completely effective in preventing bile reflux into the stomach, we prefer the Roux-en-Y diversion because it is technically easier and safer.