Modern views on the pathogenesis and treatment of alkaline reflux gastritis developing after gastric resection (literature review)

Introduction. Among patients with complicated ulcers, in 25-50% of cases there are chronic duodenal obstruction (CDO), on the other hand, the resection of the stomach itself is the cause of the disruption of the normal function of the duodenal sphincter. Data on the frequency of duodenogastric reflux in peptic ulcer and after gastric resections are very contradictory. Purpose - to present modern views on the pathogenesis and treatment of alkaline reflux gastritis that develops after gastric resection. Material and methods. Literature search was carried out in the following electronic databases: Paragraph Medicine, Web of Knowledge (ThomsonReuters), Scopus, Pubmed Medline, The Cocrane Library, Springer Link, Ebscohost Science Direct. The search period was from 2003 to 2020 (with the exception of 5 sources:). More than 250 sources have been analyzed. The review includes 40 articles on the specified topic, which were available in full text and analyzed by critical evaluation. Results. Summarizing the literature review, we can say that there are no significant reductions in the number of post-gastroresection complications, including duodeno-gastric reflux (DGR). One of the methods for the prevention of DGR is the detection of CDO in the preoperative period. The only variant of gastroenteroanastomosis that can prevent enterogastric bile reflux is a Roux-loop anastomosis. Conclusions. These patients should be operated on in clinics where surgeons are impeccably proficient in various types of operations on the esophagus, stomach and duodenum. Literature data suggest that in the majority of patients with excessive enterogastric reflux, transformation into a long loop of Roux-en-Y leads to a stable symptomatic effect for at least 3 years.