Background/aim: Enterogastric reflux of bile, and duodenal and pancreatic secretions may occur either spontaneously or, more commonly, after gastric surgery. The most reliable method in discriminating symptomatic from asymptomatic postgastric surgery refluxers, and in predicting a good clinical result after surgical diversion in the former group, is the quantitation of reflux by 99mTc-HIDA scintigraphy.
Materials and methods: In 28 normal subjects and 143 postgastric surgery patients, the enterogastric reflux (EGR) was demonstrated by 99mTc-HIDA scintigraphy on 230 occasions. The EGR index was quantitated according to two different formulae: the former one based on the amount of refluxate (percentage of maximal radioactivity of the gastric area over the total abdominal activity--EGR-Im) and the latter one based on the amount and the duration of the time of reflux (CompEGR-Im) and representing the area of the surface below the curve, which was yield by plotting EGR-Im values (obtained every 5 min for one hour) against time.
Results: Although there was a highly significant correlation of values between the two methods (p<0.0000001), the latter one was more reliable in classifying postgastric surgery patients according to the presence of reflux symptoms and the reflux index.
Conclusions: In patients with a CompEGRpIm>770 and postgastric surgery symptoms, at least some of the symptoms can be safely be attributed to enterogastric reflux.