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Laparoscopic Hiatal Hernia Repair and Roux-en-Y Conversion for Refractory Duodenogastroesophageal Reflux after Billroth I Distal Gastrectomy

Journal of Gastric Cancer 2020년 20권 3호 p.337 ~ 343
박중민, 윤성진, 김종원, Chi Kyong-Choun,
소속 상세정보
박중민 ( Park Joong-Min ) - Chung-Ang University College of Medicine Department of Surgery
윤성진 ( Yoon Sung-Jin ) - Chung-Ang University College of Medicine Department of Surgery
김종원 ( Kim Jong-Won ) - Chung-Ang University College of Medicine Department of Surgery
 ( Chi Kyong-Choun ) - Chung-Ang University College of Medicine Department of Surgery

Abstract


Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.

키워드

Gastroesophageal reflux; Billroth reconstruction; Duodenogastroesophageal reflux; Roux-en-Y; Anti-reflux surgery

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