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February 1956

Cardiac Sphincter Substitution by Interpositioned Jejunum: The Role of the Vagus in Dogs

Author Affiliations

From the Department of Surgery, University of Washington School of Medicine; Public Health Service Postdoctorate Research Fellow (Dr. Girvin).

AMA Arch Surg. 1956;72(2):241-246. doi:10.1001/archsurg.1956.01270200057010

Reflux esophagitis is a common complication of certain conditions in which the esophagogastric sphincter fails to function normally or is either incised or excised surgically. This is a frequent clinical observation and has been demonstrated experimentally as well. Recent studies in dogs in this laboratory have shown that excision of the cardioesophageal junction, even when accompanied by a vagotomy and a theoretical 100% resection of parietal cells in the proximal stomach, resulted in a high incidence of erosion and ulceration of the esophagus in the area proximal to the esophagogastrostomy. This complication occurred in all dogs receiving prolonged histamine stimulation and also occurred even when gastroduodenal ulcers failed to develop.*

Further experimental work has shown that when the esophagogastric sphincter is sacrificed, a jejunal segment interposed between the esophagus and intact stomach, accompanied by a bilateral vagotomy and Finney pyloroplasty, protects the esophagus against