P1.097. Subtotal Esophagectomy Gastric Pull Up With Cholecystectomy Has a High Incidence of Reflux Esophagitis and Gastrictube Ulcer

Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background We have experienced acute cholecystitis after esophagectomy .Therefore, cholecystectomy was performed to prevent postoperative cholecystitis . The disruption of lower esophageal sphincter, angle of His, and the denervation of the vagus nerve are the main factors that interfere with gastric motor function. Furthermore, the pressure difference between thoracic (negative) and abdominal cavity (positive) is another factor that promotes reflux across the anastomosis. Due to these factors, postoperative reflux esophagitis is frequently experienced. After cholecystectomy, due to loss of gallbladder reservoir function and decrease in antroduodenal motility, bile is not excreted by food intermittently but continuously, resulting in duodenogastric reflux. Methods We investigated postoperative reflux esophagitis and gastric tube ulcers in esophagectomy cases with and without cholecystectomy for the past three years.We investigated cholecystectomy with esophagectomy (n=65) and non-cholecystectomy with esophagectomy (n=101) in 166 cases of radical surgery for esophageal cancer in which 2-3 regions had been dissected in the past 3 years. Results There are no differences in location, TNM, gender, and PPI administration .Reflux esophagitis ( Los Angeles Classification ) of the cervical esophagus is A:0 B:2 (3%), C:5 (8%), D:3 (5%) for chole( +), A:2 (2%), B:2 (2%), C:2 (2%), and D:2 (2%) for chole(-). Gastritis was Chole( +) superficial gastritis 14 (21%), metaplasia 4 (6%), chole(-) superficial gastritis 25 (25%), metaplasia 3 (2%). However, gastric tube ulcers occurred in 5 cases (7%) of Chole(+) and 1 case of perforation, while only 1 case (1%) of gastric tube ulcers occurred in Chole(-).. Conclusion Esophagectomy, gastric pull up with cholecystectomy has a high incidence of reflux esophagitis in the neck and can also cause ulcers in the gastric tube. Therefore, care should be taken in postoperative follow.