Cholecystectomy and Duodenogastric Reflux: Reflux of Duodenal Content Induces Esophageal Carcinogenesis

Background 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. Methods 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. Results TG Rats were sacrificed at 40 th week. CLE was observed in 40%,sever dysplasia occurred in 100%,SCC was observed in 40%,ADC was observed in 30%.Sever macroscopic, microscopic and molecular alterations were observed in nearly 100% of these cases after 40th weeks of chronic duodeno-esophageal reflux. Conclusion 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 in the esophageal mucosa. We need to fully understand DGR to adequantely advise patients on the effect of cholecystectomy.