Detection of Bile Reflux into the Esophagus after Gastrectomy using a New Bilirubin Monitor

A new portable bilirubin detecting device with an inner tube to wash out the tip of the probe was developed and used to evaluate bile reflux into the esophagus in patients who had undergone partial gastrectomy. Correlations between absorbance and concentrations of total bilirubin and total bile acid were determined in vitro. In the in vivo study, the presence of duodenogastroesophageal reflex was studied in 10 controls and 20 patients who had undergone partial gastrectomy with Billroth I reconstruction (10 with reflux symptoms, 10 without symptoms). There were significant correlations between the absorbance values and concentrations of total bilirubin ( r = 0.804, p < 0.01 ) and total bile acid (r=0.888, p < 0.01 ). The percentage of time of bilirubin exposure was significantly greater in the symptomatic patients who had undergone gastrectomy ( 58.7±6.5％) than in the control subjects (3.6±1.0％) and asymptomatic patients ( 7.1±2.5％) (P < 0.01). Our new bilirubin detecting device is useful for evaluation of duodenal reflux. Reflux symptoms in patients who have undergone partial gastrectomy could be related to duodenal reflux into the esophagus.

胃切除後逆流症

十二指腸液逆流

胆汁モニタリングセンサー