Duodenogastric Reflux after Esophagectomy and Gastric Interposition

Stomach is considered the “gold standard” as an esophageal substitute after esophagectomy. Reflux disease is considered an unavoidable consequence of esophageal resection followed gastric interposition. Reflux esophagitis shows a progression from inflammation to erosions and to the development of columnar lined metaplasia. With the use of a gastric interposition, the most popular option to reconstruct the esophagus resected for malignant or benign conditions creates an in vivo model of reflux disease. Gastric interposition is far from ideal as an esophageal substitute. Reflux esophagitis and new columnar lined metaplasia should be seen as a new complication of subtotal esophagectomy.