[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.