Laparoscopic operation for gastrointestinal reflux should be considered in a patient with any of the following situation Except: (A) Barret's esophagus, (B) Daily proton pump inhibitors for symptomatic relief, (C) Esophageal stricture, (D) Significant esophageal shoening
Answer is D. .Indications for surgical treatment * Failure of drug treatment * Sliding hernia *Barrett's ulcer * Severe pain * Presence of complications like bleeding/stricture/ shoening Principles of antireflux surgeries * Operation should restore the LES pressure twice the resting gastric pressure * The adequate length of the intraabdominal oesophagus should be maintained * Apposition of diaphragmatic crurae, reduction of a hiatus hernia when present * Repaired OG junction should relax adequately during swallowing * Tension-free fundoplication should be done Ref: SRB&;s manual of surgery,3 rd ed, pg no 741