RESUMEN
Twenty-nine patients with enterogastric reflux syndrome after anti-ulcer gastric surgery underwent a revisional Roux-en-Y gastrectomy. The diagnosis of enterogastric reflux syndrome was based on symptomatology and endoscopy in the first eight patients. The latter 21 patients had, in addition, a 99mTc-HIDA scintigraphy for the documentation and measurement of reflux. An enterogastric reflux index > 20 per cent is considered to justify symptoms due to reflux. Three of the first eight patients continued postoperatively to experience the same symptoms as before. These symptoms were eventually attributed to other than enterogastric reflux syndromes. The latter 21 patients were relieved from their preoperative symptoms and classified as Visick I and II (18 patients) and Visick III (3 patients). The authors conclude that enterogastric reflux syndrome must be documented on scintigraphy before the patient is subjected to revisional anti-reflux surgery in order for failures due to misdiagnosis to be avoided.
Asunto(s)
Reflujo Duodenogástrico/diagnóstico por imagen , Iminoácidos , Compuestos de Organotecnecio , Adulto , Anastomosis en-Y de Roux/métodos , Anastomosis en-Y de Roux/normas , Diagnóstico Diferencial , Reflujo Duodenogástrico/clasificación , Reflujo Duodenogástrico/cirugía , Femenino , Estudios de Seguimiento , Gastrectomía/métodos , Gastrectomía/normas , Vaciamiento Gástrico , Grecia , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios , Cuidados Preoperatorios , Cintigrafía , Índice de Severidad de la Enfermedad , Lidofenina de Tecnecio Tc 99mRESUMEN
Serum and urine total alpha-amylase isoenzymes values were estimated in two groups of patients, who underwent either elective cholecystectomy and operative cholangiogram (group A-59 patients) or cholecystectomy without operative cholangiogram (group B - 68 patients). Serum and urine total alpha-amylase and pancreatic isoamylase (p-type) values were statistically significantly increased within the first 24 postoperative hours as compared to the preoperative levels only in group A (p less than 0.05). No clinical signs of pancreatitis were observed. Serum lipase alterations did not reach any statistically significant difference in either group. It is concluded that transient hyperamylasaemia after preoperative cholangiogram may be due to a reversible chemical pancreatitis caused by the infused opacifying agent into the common bile duct.