[Esophagojejunostomy anastomosis technique (author's transl)].

To overcome the specific problems of esophagojejunostomy, leakage and reflux, a method of end-to-side anastomosis completely surrounded by the proximal jejunal stump was developed. A proximal jejunal loop is isolated and used for isoperistaltic interposition between esophagus and duodenum. About 15 cm of the jejunal segment are left orally to the proximal anastomosis which is performed end-to-side using a single layer of interrupted sutures. The blind loop is then wrapped completely and symmetrically around the anastomosis and sutured to itself and the esophagus to keep it in place. Complete envelopment of the leakage-prone anastomosis is thus achieved. The distal end of the jejunal segment is anastomosed to the duodenum end-to-end. The technique in addition provides protection against reflux into the esophagus by gaseous distension of the proximal jejunal segment surrounding the anastomosis without impeding the passage due to a valve-like action which allows unidirectional flow. Clinical results so far are promising and show absence of leakage and/or stenosis in all cases of esophagojejunostomy operated according to the method described.