Surgical treatment of morbid obesity with reflux esophagitis.

Experience with six morbidly obese patients with symptomatic reflux esophagitis associated with hiatal hernia, the diagnoses confirmed by upper GI x-ray contrast studies and endoscopy, has been reported. Truncal vagotomy with Heineke-Mikilicz pyloroplasty and gastric bypass with Roux-en-Y gastrojejunostomy has controlled all symptoms of esophagitis and produced effective weight loss. It is suggested that if the proximal gastric pouch is no larger than 25 ml there is no need to perform truncal vagotomy and pyloroplasty.