Esophagoduodenostomy: a neglected reconstructive procedure after total gastrectomy.

Three types of esophago-enteric reconstruction are currently employed following total gastrectomy: end-to-end anastomosis, esophagus to duodenum; Roux-en-Y esophagojejunostomy; and interposition of jejunal or colonic segment between the esophagues and duodenum. For reasons not entirely clear, esophagoduodenostomy enjoys less popularity than the two alternative methods. A study of cases reviewed at the Jewish Hospital reveals equality of results in terms of mortality and morbidity. The procedure was found to have definite advantages over the others. Esophagoduodenostomy is recommended as the procedure of choice following total gastrectomy.