[Indirect antireflux procedures in gastroesophageal reflux disorders]

The authors present surgical management in patients with duodenogastroesophageal reflux in gastroesophageal reflux disorders. Currently, negative effects of alcalic biliary reflux on the esophageal mucosa have been demonstrated. It may result in serious complications of the disorder, including esophageal strictures, ulcerations, bleeding and, in particular, development of a Barrett's esophagus premalignancy which may, potentialy, result in adenocarcinoma. During 2004-2005, a total of 148 subjects were operated in the Ist Surgical Clinic for gastroesophageal reflux disorders. Most of the subjects underwent antireflux procedures, laparoscopic Rossetti modifications of fundoplication. The group of patients suffering from symptomatic biliary refluxes, confirmed on endoscopy, included 14 subjects. The patients were indicated for indirect antireflux procedures, gastric resections with gastrojejunoanastomosis using a Roux loop. After the procedure, all patients recovered from the symptoms of the disorder, which corresponded with favourable control findings on endoscopy. In patients with symptomatic biliary reflux, indirect antireflux procedures are prefered, to prevent development of esophageal reflux disorder complications.