Reflux esophagitis in patients with partial gastrectomy and Billroth I or II reconstruction

Background: Data on the occurrence of reflux esophagitis and Barrett's esophagus in patients with Billroth I or II resection is sparse. For this reason a cross-sectional study was done in order to assess reflux disease in Billroth resection. Methods: Consecutive patients were included in the study. Coincidental pathology (hiatus hernia, ulcer, esophagitis, and cancer) was noted. Results: Over a period of 12 years, 370 consecutive patients with a partial gastrectomy were seen (268 Billroth 11, 102 Billroth 1) and three groups of patients were identified. Group 1 included 64 patients (17%) with a hiatus hernia; group 2, 16 patients (4%) with reflux esophagitis; and group 3, 290 patients (78%) with only a Billroth resection. Reflux disease occurred significantly more often in men than in women (7.5% vs. 2%, p < 0.05). There was no difference in type of resection or in the presence of reflux esophagitis. Four patients had an esophageal cancer (only one adenocarcinoma). Conclusion: Only a minority of patients with partial gastrectomy has signs of esophagitis in the long term. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.