Effect of biliary reconstruction procedures on gastric acid secretion.

In 26 patients with Roux-Y choledochojejunostomy and 10 with jejunal interposition choledochoduodenostomy, gastrin-stimulated gastric acid secretion and serum levels of gastrin and secretin after feeding were examined before operation and at the time of follow-up. The follow-up levels of maximum acid output were higher than those before operation in each group, and they tended to be higher in patients with Roux-Y choledochojejunostomy (Group I) than in those with jejunal interposition choledochoduodenostomy (Group II), but the difference was not significant. There was no instance of postoperative peptic ulcer in either group. The levels of serum gastrin after feeding tended to be higher in Group II, whereas serum secretin levels were contrarily higher in Group I. The changes in these hormones could be considered not as the cause but rather as the outcome of the changes in postoperative gastric acid secretion.