Between 1985 and 1990, six patients were operated on using duodenal di
version for reflux esophagitis with scleroderma. Duodenal diversion wa
s performed twice as initial procedure and 4 times as treatment of uns
uccessful antireflux procedure performed ten years previously. Duodena
l diversion was associated with truncal vagotomy. In cases of reoperat
ion the initial reconstruction procedure was removed. An esophageal st
ricture was resected in one case. One patient with previous truncal va
gotomy and pyloroplasty underwent supra papillary diversion. There was
no postoperative death. The mean follow-up was 28 months with one pat
ient lost to follow-up. For 4 patients, the postoperative weight gain
was 10 per cent. Abnormalities of lower esophageal motility in sclerod
erma account for the poor results after classical antireflux procedure
s. In these cases duodenal diversion is indicated as primary treatment
. In cases of reoperation removal of the initial anti-reflux device is
required in association with duodenal diversion.