Postprandial proximal gastric acid pocket in patients after distal gastrectomy

Abstract

In conclusion, PPGAP is present in a minority of patients after distal gastrectomy; this finding may suggest that the gastric antrum may play a role in the genesis of the PPGAP.

Postprandial proximal gastric acid pocket and gastroesophageal reflux disease

“…Subsequent studies used the same methodology based on endoscopic-placed clips and the manometric determined LES 7,10 or manometric landmarks only. 4,6,[11][12][13][14] 99mTc-pertechnetate scintigraphy has also been used to mark PPGAP position within the stomach. 10 A fatty meal is used in most studies to determine PPGAP presence based on the physical principle of acid floating above the lipid layer of food.…”

“…10 A fatty meal is used in most studies to determine PPGAP presence based on the physical principle of acid floating above the lipid layer of food. Examples of standard meals are French fried potatoes and either fish, smoked sausage, or chicken; 3,7 pancakes with jam and an orange juice; 10 hamburger and chocolate milk; [11][12][13][14] and egg-muffin and chocolate milk. 4 PPGAP is accessed 10-15 minutes after the meal.…”

“…Interestingly, the authors did not use manometric landmarks. Subsequent studies used the same methodology based on endoscopic‐placed clips and the manometric determined LES 7,10 or manometric landmarks only 4,6,11–14 . 99mTc‐pertechnetate scintigraphy has also been used to mark PPGAP position within the stomach 10 …”

“…Our group studied PPGAP in patients after gastric surgery 11–14 . Three types of gastric operation were studied in order to determine the influence of gastric anatomy on the PPGAP.…”

“…Herbella et al. 11,13,14 showed that PPGAP is uncommon after Nissen fundoplication, distal gastrectomy, and RYGB. The suppression of the PPGAP after surgery may also be a putative factor for GERD control after RYGB.…”