[Treatment of complicated peptic esophagitis. Role of total duodenal diversion].
Total duodenal diversion was performed in 60 patients with reflux oesophagitis complicated by stricture, brachyoesophagus, endobrachyoesophagus or previous oesophago-gastric surgery. The standard operation (truncal vagotomy, antrectomy, 70 cm Roux-en Y anastomosis) was carried out in 41 patients; technical adjustments were necessary in 19 patients previously operated. One patient died of post-operative pulmonary embolism. Lasting cure of the oesophagitis was obtained within less than 3 months in 56/59 patients (93 per cent). Three-hour post-prandial pH measurements showed control of the reflux in 48/52 patients (92 p. 100). Anastomotic ulcers developed in 3 patients who did not have vagotomy. One case of complete remission of endobrachyoesophagus was observed, and 4 cases are now in partial remission. Digestive tract sequelae were found in 9 patients who had undergone surgery, but they were disabling in only one of these. These results suggest that total duodenal diversion is a suitable treatment of complicated reflux oesophagitis.
Perniceni
T
T
Université Paris VII, Hôpital Beaujon, Clichy.
Mosnier
H
H
Gayet
B
B
Fékéte
F
F
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004386:Duodenum / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery; D004942:Esophagitis, Peptic / Q000150:complications / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000601:surgery; D013536:Suture Techniques; D015167:Vagotomy, Truncal
Traitement des oesophagites peptiques compliquées. Place de la diversion duodénale totale.