Biliopancreatic reflux esophagitis: the role of the Roux-en-Y long-limb diversion

Since the end of the nineteenth century, numerous operations were designed to relieve reflux of duodenal content into the stomach and hence the esophagus under certain conditions. The basic surgical principle remains almost invariably the confection of a long Roux-en-Y jejunal limb. The most effective remedial operations are the total duodenal diversion and the supra papillary duodenal diversion. Although the latter technique seems to avoid some of the worst postoperative side effects caused by antrectomy and vagotomy, its feasibility implies the absence of a previous gastrojejunostomy.