Complications of repeated operations to control esophageal reflux (esophagogastrocutaneous and esophagogastropericardial fistulas).

Iatrogenic injury to the distal esophagus and gastric cardia with subsequent fistula formation may occur at times following repeated direct operative attempts to control reflux esophagitis. At re-operation when this problem occurs, the indirect operative procedure of Roux-en-Y diversion is a safe, effective and preferable method to control persistent reflux esophagitis.