The role of gastrin in the treatment of sliding hiatal hernia with reflux using the reefing method of fundoplication
Sifers, E.C.; Taylor, T.L.; Rick, G.G.; Hartman, C.R.; Tretbar, L.L.
Surgery Gynecology and Obstetrics 143(3): 376-380
1976
ISSN/ISBN: 0039-6087 PMID: 785638 Document Number: 97683
Findings in this study correlated a low circulating gastrin level with an incompetent lower esophageal sphincter mechanism and abnormal reflux. Such reflux, in amounts causing esophagitis distally, was treated surgically by a mechanically simple method of fundoplication. The success of this reefing method of fundoplication was explained by using physiologically active sling fibers of the gastric fundus to augment the lower esophageal sphincter. Available gastrin was used more effectively in this manner. The high incidence of associated foregut diseases suggested an embryologic factor in the development of gastroesophageal reflux. The dilated hiatus and its attendant hernia had no apparent relationship to the development of reflux esophagitis. The term symptomatic sliding hiatal hernia, therefore, seemed to be a diagnostic and therapeutic misnomer.