Reflux stricture of the esophagus following partial gastrectomy for duodenal ulcer

Abstract

Twenty-five patients developed reflux stricture of the esophagus following partial gastrectomy for duodenal ulcer. Stricture formation was rapid and progressive. Postgastrectomy nasogastric intubation and immobilization were significantly longer in these patients than in controls. Only 9 patients had a dilatable stricture. The dilatability rate was significantly lower than in patients with primary reflux strictures of the esophagus. All patients but 1 failed to respond to conservative management based on gastric secretion blockade and antacids. Following dilatation, surgical control of reflux by conversion or/and antireflux procedure was carried out. Only the conversion of a previous gastrectomy to a Roux-en-Y gastrojejunostomy combined with an antireflux procedure gave satisfactory long-term results, while each of these procedures applied alone was insufficient. Sixteen patients with undilatable stricture underwent resection or bypass procedures. Four patients died. The remaining 12 patients are symptom free and have no endoscopic signs of esophagitis. © 1992 S. Karger AG, Basel.