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Highly Selective Vagotomy, Posterior Gastropexy, and Calibration of the Cardia for Reflux Esophagitis

  • A. Csendes
Conference paper

Abstract

Posterior gastropexy used as one of the definitive antireflux operations in patients with reflux esophagitis was introduced by Hill [28]. The basic principle of this procedure is to anchor the anterior and posterior phreno-esophageal fascial bundles to the median arcuate ligament, thus creating a long and permanent intraabdominal segment of the esophagus. Larraín modified this operation by adding the concept of calibration of the cardia [31], because several surgical observations indicated that the distal portion of the esophagus and the esophagogastric junction were both dilated in patients with reflux esophagitis [13, 29, 30,43]. This surgical maneuver aimed to decrease the diameter of the muscular esophagogastric junction (or “cardias”) to a normal or lesser than normal diameter. This was first controlled by invaginating the stomach by a finger against the distal end of the esophagus and this step was accepted by Hill and other surgeons [26, 30, 41, 43]. We have employed this surgical procedure for several years [13, 32,42] but much surgical experience and some complications seen during and late after surgery led us to introduce some modifications to the technique [21, 24, 33, 36, 44, 46].

Keywords

Duodenal Ulcer Hiatal Hernia Reflux Esophagitis Esophageal Stricture Esophagogastric Junction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • A. Csendes
    • 1
  1. 1.Department of SurgeryUniversity of ChileSantiagoChile

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