Between 1973 and 1978, we have treated 34 patients with alkaline reflux
gastritis. All but one had a history of prior gastric surgery. Ten patients had severe
diarrhea due to dumping or
vagotomy or both. Eleven of the patients had undergone 17 unsuccessful remedial operations. Except for one patient whose
gastrojejunostomy was dismantled and two patients who had interposition of a Henle loop between the stomach and the duodenum, all the patients were managed by construction of a 40 cm Roux-en-Y limb. In 10 patients with
diarrhea,
a 7 to 8 cm
antiperistaltic segment was positioned 80 cm distal to the stomach. Ancillary procedures such as
vagotomy and Hill
hiatal hernia repair were done in some of the patients. Bile
gastritis was well controlled by the 40 cm Roux limb. The short reversed segment placed 80 cm from the stomach effectively controlled
diarrhea whether it was due to dumping or
vagotomy and did not cause any of the problems of
gastric stasis that we and others have observed with reversed segments positioned next to the stomach.