Late Endoscopic and Histopathologic Changes in Patients with Billroth II Gastrectomy for Duodenal Ulcer

25 patients who had gastric resection for duodenal ulcer 10-13 years ago were examined endoscopically. Mucosal biopsies were taken. Endoscopically 13 were normal, 12 had gastritis and 14 had bile reflux. 9 reflux and 3 nonreflux patients showed gastritis. 8 patients had neither reflux nor gastritis. In endoscopically normal patients 5 had minimal, 7 had reactive mucosal changes and 1 had chronic gastritis. In 12 patients who had gastritis endoscopically, 4 showed minimal mucosal changes and 7 showed chronic gastritis. 3 reflux patients had minimal, 5 had reactive mucosal changes and 6 had chronic gastritis histopathologically. 2 non-reflux patients had minimal, 6 reactive mucosal changes and 2 has chronic gastritis. Mean pH of reflux patients was 4.508 ± 0.418 and non-reflux patients 4.26 ± 0.629. The difference was not significant (P>0.05). Mean gastrin level in reflux patients was 68.89 ± 12.81 pg/ml, in nonreflux patients 56.22 ± 9.79 pg/ml. The difference was also not significant (P>0.05). Gastritis is a serious gastrectomy complication. Bile reflux is one of the causes, but not through the pH and gastrin changes. 13 years were not sufficient to produce malignant changes. Therefore, these patients should be pursued at frequent intervals both endoscopically and histopathologically.