{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T19:14:31Z","timestamp":1771269271797,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,5,12]],"date-time":"2006-05-12T00:00:00Z","timestamp":1147392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Alkaline gastritis is caused by excessive reflux of alkaline duodenal content into the stomach or gastric remnant following procedures that resect or defunctionalize\/deviate the pyloric sphincter. The symptoms may be intractable and surgery may be required in a selected subgroup of patients. The goal of this study was to present our experience regarding surgical management of alkaline reflux gastritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>During a 15\u2010year period, 26 patients underwent surgery for the management of refractory alkaline reflux gastritis. Preoperative evaluation included a detailed history, endoscopy, and histology; alkaline reflux gastritis was characterized as mild, moderate, or severe based on the results of this evaluation. The patients underwent remedial gastric surgery when conservative management was ineffective and the patient\u2019s symptoms\u2014despite medical treatment\u2014persisted for at least 2 years and affected quality of life. Most patients had previously undergone subtotal gastrectomy\/gastrojejunostomy (the Billroth II procedure) (22\/26, 84.6%); three patients (11.5%) had vagotomy and gastrojejunostomy, and 1 patient (3.9%) had vagotomy and pyloroplasty. In most patients (14\/26, 54%), symptoms appeared 1\u20133 years after initial gastric surgery. Epigastric pain and bilious vomiting were reported by all (26\/26, 100%) and by 25\/26 (96%) of patients, respectively, while anemia and weight loss were observed in 11\/26 (42.3%) and 18\/26 (69.2%), respectively. Severe, moderate, and mild gastritis was present in 12, 9, and 5 patients, respectively. Most patients (18\/26, 69%) were treated by Roux\u2010en\u2010Y anastomosis, and 8 (31%) by the Tanner (Roux\u201019) procedure. Long\u2010term follow\u2010up was completed in 23 patients (mean: 7.3 years), by clinical assessment (<jats:italic>n<\/jats:italic> = 18), or by questionnaire (<jats:italic>n<\/jats:italic> = 5). Results were assessed by using the Visick grading.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One patient died from massive pulmonary embolism (mortality: 3.8%). Morbidity was 57%, with the Roux stasis syndrome being the most frequent complication (<jats:italic>n<\/jats:italic> = 9). Both procedures achieved good early results, particularly regarding pain relief and absence of vomiting (84% and 96%, respectively). Endoscopic findings were ameliorated 6\u00a0months following surgery, whereas histological changes remained relatively unchanged. Eleven patients (47.8%) reported excellent (Visick I), 9 (39.2%) good, and 3 (13%) unsatisfactory late results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Remedial gastric surgery was effective and achieved symptom relief in a significant percentage (87%) of our patients. The Roux stasis syndrome is a frequent complication following Roux\u2010en\u2010Y reconstruction, but quality of life is significantly improved. Careful patient selection is essential to achieve satisfactory results.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0418-x","type":"journal-article","created":{"date-parts":[[2006,5,16]],"date-time":"2006-05-16T07:59:21Z","timestamp":1147766361000},"page":"1043-1049","source":"Crossref","is-referenced-by-count":28,"title":["Alkaline Reflux Gastritis: Early and Late Results of Surgery"],"prefix":"10.1002","volume":"30","author":[{"given":"Basile","family":"Zobolas","sequence":"first","affiliation":[{"name":"Department of Surgery \u201cMetaxa\u201d Hospital Botasi 51 str 18537 Peireas Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George H.","family":"Sakorafas","sequence":"additional","affiliation":[{"name":"First Propaedeutic Surgical Clinic Athens University, Medical School, Hippocration General Hospital V.Sofias 114 Ave. 11527 Athens Greece"},{"name":"George H. Sakorafas Arkadias 19\u201321 GR\u2010115 26 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Kouroukli","sequence":"additional","affiliation":[{"name":"First Propaedeutic Surgical Clinic Athens University, Medical School, Hippocration General Hospital V.Sofias 114 Ave. 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikes","family":"Glynatsis","sequence":"additional","affiliation":[{"name":"First Propaedeutic Surgical Clinic Athens University, Medical School, Hippocration General Hospital V.Sofias 114 Ave. 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Peros","sequence":"additional","affiliation":[{"name":"First Propaedeutic Surgical Clinic Athens University, Medical School, Hippocration General Hospital V.Sofias 114 Ave. 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Bramis","sequence":"additional","affiliation":[{"name":"First Propaedeutic Surgical Clinic Athens University, Medical School, Hippocration General Hospital V.Sofias 114 Ave. 11527 Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,5,12]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800711011"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.4485.941\u2010a"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.39.5.524"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01655337"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1997.01430270031005"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.25.9.975"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8553(21)00132-1"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(05)80131\u2010X"},{"key":"e_1_2_5_10_2","first-page":"384","article-title":"The influence of cholecystectomy on the duodenogastric reflux of bile","volume":"36","author":"Hubens A","year":"1989","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_5_11_2","first-page":"648","article-title":"Mixed reflux of gastric and duodenal juices is more harmful to the esophagus than gastric juice alone","volume":"180","author":"Kauer WKH","year":"1995","journal-title":"Ann Surg"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198008000-00007"},{"key":"e_1_2_5_13_2","first-page":"97","article-title":"Indications, technical modalities, and results of duodenal switch operation for pathologic duodenogastric reflux","volume":"46","author":"Klingler PJ","year":"1999","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)45331-4"},{"key":"e_1_2_5_15_2","first-page":"236","volume-title":"Surgical treatment of digestive disease","author":"Ritchie WP","year":"1990"},{"key":"e_1_2_5_16_2","first-page":"648","article-title":"Isoperistaltic jejunal interposition for intractable postgastrectomy alkaline reflux gastritis","volume":"180","author":"Aranow JS","year":"1995","journal-title":"J Am Coll Surg"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80600-2"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199002000\u201000018"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199405000-00002"},{"key":"e_1_2_5_20_2","first-page":"305","volume-title":"Appleton\u2010Century\u2010Crofts","author":"Hinder RA","year":"1987"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80574-4"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(06)80017-6"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1992.01420030057011"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199004123221502"},{"key":"e_1_2_5_25_2","first-page":"765","article-title":"Management of gastric emptying disorders following the Roux\u2010en\u2010Y procedure","volume":"104","author":"Hinder RA","year":"1988","journal-title":"Surgery"},{"key":"e_1_2_5_26_2","first-page":"69","article-title":"An alternative to Roux\u2010en\u2010Y for treatment of bile reflux gastritis","volume":"166","author":"Stiegmann G","year":"1988","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80011-X"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.18004016006"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197410000-00017"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198710000-00003"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)45691-4"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-005-0418-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-005-0418-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-005-0418-x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T13:03:16Z","timestamp":1704718996000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-005-0418-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5,12]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2006,6]]}},"alternative-id":["10.1007\/s00268-005-0418-x"],"URL":"https:\/\/doi.org\/10.1007\/s00268-005-0418-x","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5,12]]}}}