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Diseases of the Esophagus pp 1272–1279Cite as

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

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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].

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Chile, Santiago, Chile

    A. Csendes

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  1. A. Csendes
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Editors and Affiliations

  1. Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, D-8000, Munich 80, Federal Republic of Germany

    J. R. Siewert M.D. FACS (Professor of Surgery) & A. H. Hölscher M.D. (Professor of Surgery) & 

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© 1988 Springer-Verlag

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Csendes, A. (1988). Highly Selective Vagotomy, Posterior Gastropexy, and Calibration of the Cardia for Reflux Esophagitis. In: Siewert, J.R., Hölscher, A.H. (eds) Diseases of the Esophagus. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-86432-2_277

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  • DOI: https://doi.org/10.1007/978-3-642-86432-2_277

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-86434-6

  • Online ISBN: 978-3-642-86432-2

  • eBook Packages: Springer Book Archive

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