P1.025. The Role of Bile Acid and Pancreatic Juice for Reflux Esophagitis After Total Gastrectomy in Rat Model

Topic Benign Disease: Gastro-Esophageal Reflux and Hiatal Hernia Background Esophagitis after total gastrectomy has been associated with the reflux of duodenal content ( biliary and pancreatic juice ) into the esophagus. This study is to determine which fraction of the duodenum content reflux, pancreatic juice or bile acids contributes to the development of reflux esophagitis. Methods 8 week Wistar Rat were used. Three weeks after operation, all rats were euthanized and the esophagus was evaluated histologically. Esophageal injury was evaluated by macroscopic and microscopic findings. Results 1.Macroscopic finding: In TG rats, the esophageal wall was thickened and covered with whitish nodular patches that gave it a cobblestone appearance. Together with the changes, longitudinal ulcerations located primarily in the middle and lower thirds of the esophagus were observed. However, the gross appearance of the esophagus from TG+P group showed only scattered erosions. The ulcer score in TG+P was significantly lowered compared to TG. 2. Microscopic finding: TG group developed large and long longitudinal ulcers, sever infiltration of inflammatory cells and hyperplasia of the epidermis and basal cell in the lower and middle portions of the esophagus. The inflammatory cell infiltration scores and hyperplasia scores were significantly decreased in the TG+P group compared to TG group. Conclusion The reflux of pancreatic juice alone is probably not significant development of reflux esophagitis after total gastrectomy. The reflux of bile acid mixed with pancreatic juice to esophagus caused sever reflux esophagitis after total gastrectomy.