胃全摘出術後の逆流性食道炎予知の為の一工夫

抄録

Reflux esophagitis in the total gastrectomized patients is not uncommon. There have been few attempts made to objectively evaluate reflux of duodenal juice to lower esophagus. We tried objectively to evaluate reflux of bilirubin in duodenal juice.
We introduced a duodenal tube with olive tip to lower esophagus under the examination of X-ray and aspirated the duodenal juice with syringe. We examined the presence of bilirubin in duodenal juice according to Watson-Hawkinson's method.
In the patients operated as devised by Prof. Tomoda, reflux of bilirubin to lower esophagus did not occur and these patients were completely free from complaints of esophagitis. During one year after examination, we did not observe the occurrence of reflux esophagitis in these patients.
In some instances, we introduced a duodenal tube into the jejunum interposed between esophagus and duodenum and examined the regurgitation of bilirubin in interposed jejunum. It seemed that bilirubin could regurgeitate in jejunum at 25cm from jejuno-duodenal anastomosis.