Abstract
An operation to prevent reflux was carried out in 36 patients with oesophageal varices; its aim was to prevent ulceration of the oesophageal mucosa due to gastric or duodenal secretions. The anti-reflux plasty consists of a distal gastrectomy with orthograde, isoperistaltic interposition of 20 cm. of jejunum between the gastric remnant and the duodenum, and fixation of the fundus and fornix. During the first three months, and even somewhat later, there was a little passage of contrast from the interposed jejunum into the stomach and duodenum. The reflux from the duodenum was, however, very small and only reached the vicinity of the stoma so that a duodeno-gastric reflux could be practically excluded. The fundus-fornix fixation resulted in absence of radiologically demonstrable gastro-oesophageal reflux. The interposed jejunal loop took over in part the function of the stomach, regulated gastric emptying and acted as a valve during upper gastro-intestinal transport.
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