The Influence Of Alkaline Reflux Gastritis After Distal Radical Gastrectomy By Roux-en-Y And Billroth ? Anastomosis Reconstruction

Objective:Through the comparison of diffence in the operation time,postoperative gastrointestinal drainage,postoperative hospital stay,bilious vomiting,feel of under xiphoid continued burning and incidence of adverse reactions after 1 year follow-up endoscopy showed anti bile and pancreatic juice flow by Roux-en-Y and Billroth II anastomosis reconstruction after distal radical gastrectomy.Study on the Influence of alkaline reflux gastritis after distal radical gastrectomy by Roux-en-Y and Billroth II anastomosis reconstruction.Methods:A total of 97 distal radical gastrectomy patients in need and followed-up selected from August,2014 to March,2016 in Affiliated Hospital of Tai shan Medical College gastrointestinal surgery were divided into Roux-en-Y 55 cases(group A)and Billroth-II 42 cases(B group)according to the reconstruction of digestive tract.Compare with the diffence in the operation time,postoperative gastrointestinal drainage,postoperative hospital stay,bilious vomiting,the feel of under xiphoid continued burning and incidence of adverse reactions after 1 year follow-up endoscopy showed anti bile and pancreatic juice flow.Results:The average operation time was 211.09±14.19 min in grope A and 187.63±13.37 min in grope B,the difference was statistically significant(P<0.05);The average amount of postoperative gastrointestinal drainage was 158.16±81.97 mL in grope A and 363.03 ±82.66 mL in grope B,the difference was statistically significant(P<0.05);The average postoperative hospital stay was 13.81±4.24 d in grope A and 15.16±5.75 d in grope B,the difference was not statistically significant(P>0.05);There were 1 cases of bilious vomiting after operation in grope A and 12 case in grope B,the rate was 1.82 % and 28.57 %,the difference was statistically significant(P<0.05);There were 3 cases of under xiphoid continued burning after operation in grope A and 13 case in grope B,the rate was 5.45% and 30.95 %,the difference was statistically significant(P<0.05);The occurrance of anti bile and pancreatic juice flow by endoscopy after 1 year follow-up showed mild regurgitation in grope A is 4 cases,the incidence rate was 7.67 %,2 cases of severe regurgitation,the incidence rate was 3.64 %.The total number of postoperation reflux was 6 cases.In grope B,there were 28 cases of mild regurgitation and 14 cases of severe regurgitation.The rate were 66.67 % and 33.33 %.The total number of postoperation reflux about grope B was 42 cases.The difference was statistically significant compared with grope A and B(P< 0.05).Conclusion:Depite of a slight increase in operation by Roux-en-Y anastomosis reconstruction compared with Billroth II anastomosis reconstruction after distal radical gastrectomy,it can significantly reduce the the average amount of postoperative gastrointestinal drainage,the occurrance of bilious vomiting after operation and the feel of under xiphoid continued burning.It can effctively reduce the occurrance of alkaline reflux gastritis after distal radical gastrectomy by Roux-en-Y anastomosis reconstruction which significantly improve the quality of patient's life.It is a relatively safe,feasible and effective reconstruction method which is worthy of promoting and applicating.