DUODENOGASTRIC REFLUX OF BILE-ACIDS, GASTRIN AND PARIETAL-CELLS, AND GASTRIC-ACID SECRETION BEFORE AND 6 MONTHS AFTER CHOLECYSTECTOMY

In order to evaluate the effect of cholecystectomy on the gastric mucosa, the duodenogastric reflux of total and single bile acids, the number of parietal and gastrin cells, and the volume of gastric acid secretion were examined in 15 patients with gallstones and functioning gallbladders before and 6 months after cholecystectomy. The duodenogastric reflux of the total bile acids increased from a mean preoperative value of 1.9 μmol/hour to a mean postoperative value of 21 μmol/hour (p=0.008). The duodenogastric reflux of all single bile acids increased after cholecystectomy, with a higher increase in glycoconjugated compared with tauroconjugated bile acids. The parietal cells decreased from a mean preoperative value of 82.8 to a mean postoperative value of 68.7 (p=0.05), whereas there was only a mild increase in the number of gastrin cells; the output of gastric acid remained unchanged. The variation of the gastrin cells before and after cholecystectomy was negatively correlated only with the variation of taurocholic acid (r=−0.50, p=0.05), while the variation of the parietal cells was mildly correlated with all single bile acids (r=0.35–0.50, 0.05<p<0.02). These findings show an increased duodenogastric reflux of bile acids 6 months after cholecystectomy with a mild morphologic alteration of the gastric mucosa. © 1990, Reed Publishing USA. All rights reserved.