Clinical and Endoscopic Outcomes of De Meester Switch in Duodenogastric Alkaline Reflux Disease: A Retrospective Analysis with Mid-Term Follow-up
Haseki Tıp Bülteni, cilt.63, sa.2, ss.104-111, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 63 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/haseki.galenos.2025.35744
- Dergi Adı: Haseki Tıp Bülteni
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.104-111
- Trakya Üniversitesi Adresli: Evet
Özet
Aim: By presenting endoscopic, symptomatic, and quality-of-life outcomes with mid-term follow-up, this study aims to contribute to the limited body of evidence regarding the results of the De Meester Switch method for duodenogastric alkaline reflux disease (DGAR-D). Methods: Between 2017 and 2023, laparoscopic De Meester Switch surgery was performed on 30 patients with DGAR-D symptoms for over three years. The total bilirubin (TB) and direct bilirubin (DB) levels were measured in the gastric reflux content and serum at baseline and the last follow-up. In addition, the patient’s baseline and postoperative DGAR-D symptoms were evaluated in the sixth, twelfth, and last follow-up months. The Reflux Disease Questionnaire (RDQ) was used retrospectively to assess the patient’s quality of life. Results: Before surgery, most patients experienced nausea (76.6%), epigastric pain (80%), bloating (90%), heartburn (76.6%), bilious vomiting (56.6%), and sore throat (53.3%). Moreover, 93.3% of those who endured these symptoms for 3-12 years found no relief with medical treatment. Post-surgery, all symptoms significantly decreased (p<0.001). At a 34-month follow-up, some experienced persistent nausea and bloating (13.3%), epigastric pain (20%), heartburn, and sore throat (6.6%). However, bilious vomiting and biliary intestinal fluid stasis resolved entirely (100%). Preoperative gastric aspirate TB and DB levels were 2.4 and 2.1 mg/dL, respectively, reducing to 0.4 and 0.2 mg/dL postoperatively. The RDQ score significantly decreased from 82.21±3.10 to 31.13±3.09 at the last follow-up, with no observed mortality. Conclusion: The De Meester Switch can prevent the reflux of bilious duodenal contents into the stomach in patients with DGAR-D and significantly reduce complaints. This treatment is safe and effective when applied laparoscopically.