Reflux Gastritis Surgery

Alkaline reflux gastritis occurs more than 1 to 2 years after partial gastrectomy. It is generally believed that due to the loss of the pyloric sphincter, bile continues to flow back into the stomach. The bile salts and lysolecithin destroy the gastric mucosal barrier. A large amount of reverse hydrogen permeation in the gastric juice causes the mast cells to release histamine, causing gastric mucosal congestion, edema, inflammation, hemorrhage, erosion and other diseases. Its clinical manifestations are typical triads: 1 sustained burning pain under the xiphoid process, increased after eating, antacids are ineffective; 2 biliary vomiting, pain after vomiting remains; 3 weight loss. In addition, there is anemia caused by a small amount of bleeding, and the gastric juice is low in acid or acid-free. Severe cases should be treated surgically. Treatment of diseases: reflux gastritis after surgery, duodenogastric reflux and bile reflux gastritis Indication Biro I gastrectomy and Biro II gastrectomy Contraindications It is a chronic gastritis characterized by significant eosinophil infiltration in any layer or layer of the stomach wall. Preoperative preparation The reflux fluid stays in the stomach for a long time, the pH rises, and the aerobic bacteria and anaerobic bacteria in the residual stomach are more likely to grow. These bacteria can cause the bile salts to liberate and cause inflammation of the gastric mucosa, thereby causing symptoms. Surgical procedure 1. For the reflux gastritis after Biro I gastrectomy, the gastroduodenal anastomosis can be removed, and a squirming intestinal fistula with a length of about 16-20 cm is placed between the stomach and the duodenum. Good anti-reflux effect. The duodenal anastomosis can also be removed, the duodenal stump can be sutured, and a long-arm Rox-Y anastomosis of about 50-60 cm long can be reconstructed. 2. For reflux gastritis after Biro II gastrectomy, if the input sputum is shorter than 15cm or the colon is posterior, the patient can be cut at the proximal stenosis of the jejunum, and the proximal gastric stump will be sutured. The jejunum of the output section is flanked by the end of the jejunum near the duodenum. The distance between the anastomosis and the gastric stump is preferably 50-60 cm. 3. If the original surgical system is pre-colonial anastomosis or the input of the jejunum is longer than 20cm, the Tanner-19 procedure can be changed. That is, the input jejunum segment is cut at a distance of 10-15 cm away from the gastric anastomosis, and the proximal side of the proximal stomach is aligned with the output end of the output . An annular anastomotic sputum is formed, and the output sacral sac segment 60 cm away from the anastomotic stoma of the original stomach jejunum is anastomosed to the end of the stenosis segment near the duodenum side, that is, Tanner-19 is completed. formula. complication Sour acid: Even if you can smell sour, it is due to the weakness of the spleen and stomach or excessive diet, resulting in a stagnant diet. If the mouth is accompanied by bitterness and heartburn, both rib pains, this is caused by liver and stomach. And the result should be diarrhea.