Department of Surgery, Kindai University, JapanFulltext PDF
Cholecystectomy is a very common operation. Cholecystectomized patients have an increased reflux of bile and pancreatic juice from the duodenum to the stomach and a greater incidence of duodenogastric reflux (DGR). There is an increased chance for duodenal juice to enter the esophagus. Reflux of duodenal contents can induce mucosal injury and promote tumorigenesis. Therefore, we made a rat reflux model which was created a esophago-duodenostomy with total gastrectomy in order to permit chronic reflux of duodenal contents into the esophagus. Sever macroscopic, microscopic and molecular alterations were observed in nearly 100% of the cases after 40th weeks of chronic duodeno-esophageal reflux. Duodenal juice (especially, bile acid) has been found to induce the esophageal cancer in our animal model. Therefore, cholecystectomy is associated with a moderately increased risk of esophageal cancer, possibly by the toxic effect of refluxed duodenal juice (especially, bile acid) on the esophageal mucosa. We need to fully understand DGR to adequately advise patients on the effects of cholecystectomy.
Hashimoto N. Cholecystectomy and Duodenogastric Reflux-: Reflux of Duodenal Content Induces Esophageal Carcinogenesis. Clin Surg. 2018; 3: 1867.