Document Detail

Total duodenal diversion in the treatment of complicated peptic oesophagitis.
MedLine Citation:
PMID:  3208045     Owner:  NLM     Status:  MEDLINE    
Total duodenal diversion (TDD) has been carried out in 59 patients with complicated forms of peptic oesophagitis (acquired short oesophagus, columnar lined oesophagus, previous oesophagogastric surgery, stenosis). A standard procedure (truncal vagotomy, antrectomy and gastrojejunal anatomosis using a 70 cm Roux-en-Y loop) was performed in 41 patients, and some technical adjustments were required in 18 patients previously operated on. One patient died from postoperative pulmonary embolism. Bowel movements were resumed before the fifth postoperative day in 93 per cent of patients (54/59). Early postoperative complications (gastroparesis, 5; fistula, 1; subsequent operation, 1) occurred in 12 per cent of patients. Stabilization of the oesophagitis was achieved in less than 3 months in 95 per cent of cases (55/58). There were two cases of regression of columnar lined oesophagus. A 3-h postprandial pH assessment showed that the reflux had been controlled in 92 per cent of cases (47/51). One patient who still had an acid reflux died subsequently of a perforated oesophageal ulcer. Three anastomotic ulcers occurred in eight patients who did not have vagotomy. Digestive side-effects have been observed in nine patients, but only in one case were they crippling. Our results suggest that TDD is a suitable form of treatment for complicated forms of peptic oesophagitis.
T Perniceni; B Gayet; F Fékété
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  75     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1988 Nov 
Date Detail:
Created Date:  1989-02-17     Completed Date:  1989-02-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1108-11     Citation Subset:  AIM; IM    
Université Paris VII, Department of Digestive Surgery, Hôpital Beaujon, Clichy-Paris, France.
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MeSH Terms
Duodenum / surgery*
Esophagitis, Peptic / complications,  surgery*
Follow-Up Studies
Hydrogen-Ion Concentration
Middle Aged
Postoperative Complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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