A loop gastrojejunostomy is used only when absolutely required for type I, II, or III injuries as it compromises the possibility of a future gastric pull-up for esophageal reconstruction. We employ a loop gastrojejunostomy (GJ) mainly in patients with poor general condition where resection would be hazardous. When doing a loop gastrojejunostomy, the surgeon must be prudent, avoiding a retrocolic or a non-dependant GJ. A retrocolic GJ may interfere with the middle colic arcade and make mobilization of the colon at a later date for esophageal bypass more difficult or sometimes impossible. A non-dependant GJ not only fails to drain the stomach but also produces recalcitrant bile reflux, compromising the quality of life of the patient.
There have been a few reports on the use of pyloroplasty, either a Heineke–Mickulicz type or a Y–V flap [6, 24].This has not been our practice. Augmentation gastroplasty has also been proposed as a means of increasing the volume of the stomach [25]. Balloon dilatation of the strictured pylorus has been known to be an insufficient procedure in managing patients with corrosive burns. However, Kochhar et al. have reported encouraging results with the use of endoscopic balloon dilatation for corrosive pyloric strictures